| Up Dental Pllc | |
|
1502 E 14th St Brooklyn NY 11230-7283 | |
| (718) 709-4611 | |
| Not Available |
| Full Name | Up Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 1502 E 14th St, Brooklyn, New York |
| Authorized Official Name and Position | Nadia Poustovoit (OWNER) |
| Authorized Official Contact | 7187094611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Up Dental Pllc 2952 Brighton 3rd St Ste 201 Brooklyn NY 11235-7078 Ph: (718) 975-4334 | Up Dental Pllc 1502 E 14th St Brooklyn NY 11230-7283 Ph: (718) 709-4611 |
| NPI Number | 1225290547 |
|---|---|
| Provider Enumeration Date | 06/27/2008 |
| Last Update Date | 12/07/2023 |
| Medicare PECOS PAC ID | 7517313109 |
|---|---|
| Medicare Enrollment ID | O20231102002690 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225290547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 038032 (New York) | Primary |
| Provider Name | Gennady Dranovsky |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1639393754 PECOS PAC ID: 0547394595 Enrollment ID: I20100813000050 |
| Provider Name | Nadia Poustovoit |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1831117860 PECOS PAC ID: 6709232390 Enrollment ID: I20231102002675 |
| Provider Name | Avraham Kolontarov |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1336763614 PECOS PAC ID: 2567812464 Enrollment ID: I20231219000271 |
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