BROOKSIDE FAMILY DENTAL CORP (NPI# 1053585612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053585612 |
| Entity Type | Organization |
| Organization Name | BROOKSIDE FAMILY DENTAL CORP |
| Other Organization Name | BROOKSIDE FAMILY DENTAL |
| Practice Address |
399 Hoover Ave Suite 1 Bloomfield NJ 07003 |
| Practice Telephone | 9735666161 |
| Practice Fax Number | 9735660866 |
| Mailing Telephone | 9735666161 |
| Mailing Fax Number | 9735660866 |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |
| Authorized Official Name | KINDA HANNA YACOUB (DDS) |
| Authorized Official Telephone | 9735666161 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D1020914 | NJ | Dental Providers |
| Other Name | Type Code |
|---|---|
| Brookside Family Dental | Former Legal Business Name - Organization |
| Street Address |
399 HOOVER AVE SUITE 1 |
| City | BLOOMFIELD |
| State | NJ |
| Zip Code | 07003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376582734 | Lori Ann Colyer-aversa | Pediatrics | 399 Hoover Ave, Suite 5, Bloomfield, NJ 07003-3924 | 2006-06-04 |
| 1235522194 | Primary Care Partners, LLC | Pediatrics | 399 Hoover Ave, Suite 5, Bloomfield, NJ 07003-3924 | 2015-03-16 |
| 1992091573 | Mounzer Yacoub | Obstetrics & Gynecology | 399 Hoover Ave, Suite #1, Bloomfield, NJ 07003 | 2011-06-22 |
| 1144523390 | Shavon Leigh Jackson-michel | Naturopath | 399 Hoover Ave, Suite 8, Bloomfield, NJ 07003-3924 | 2010-12-09 |
| 1508097122 | Mikyle Shakira Byrd-vaughn | Naturopath | 399 Hoover Ave, Suite 9, Bloomfield, NJ 07003-3924 | 2009-07-30 |
| 1871789396 | Melissa Brinton | Social Worker | 399 Hoover Ave, Bloomfield, NJ 07003-3924 | 2007-09-18 |
| 1972638070 | Kinda Hanna Yacoub | Dentist | 399 Hoover Ave, Suite #1, Bloomfield, NJ 07003 | 2007-02-22 |
| 1356429807 | Maria M Yerovi | Pediatrics | 399 Hoover Ave, Suite 4, Bloomfield, NJ 07003 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316560501 | Delores Heart,llc | Respite Care | Delores Heart, 17 Dodd St. Ste A5, Bloomfield, NJ 07003 | 2020-05-21 |
| 1235798505 | Tina Rivera | Physical Therapy Assistant | A Team Approach, Pt 265 Broad Street, Suite 4, Bloomfield, NJ 07003 | 2019-06-11 |
| 1144709239 | Jennifer Stuart | Social Worker | 27 Park Place, Apt. 13, Bloomfield, NJ 07003 | 2018-08-09 |
| 1992212179 | Kristina Camille P Manapat | Student in an Organized Health Care Education/Training Program | 1690 Broad St., Bloomfield, NJ 07003 | 2018-01-09 |
| 1760993224 | Vivian Arroyo | Counselor | 76 Baldwin Pl, Bloomfield, NJ 07003 | 2017-10-23 |
| 1942719653 | Savita Singh | Dentist | 40 Conger Street, 1402b, Bloomfield, NJ 07003 | 2017-09-26 |
| 1942729926 | Moya Mathison | Counselor | 27 West St # 5a, Bloomfield, NJ 07003 | 2017-09-11 |
| 1801319512 | Janice Rainford | Counselor | 267 Broughton Ave # 2, Bloomfield, NJ 07003 | 2017-07-25 |
| 1154841468 | Nhat Minh Nguyen | Nurse Practitioner | 3 Donald St, Apt. D, Bloomfield, NJ 07003 | 2017-06-27 |
| 1578091872 | Janice M. Steel | Physical Therapy Assistant | 265 Broad Street, Suite 4, Bloomfield, NJ 07003 | 2017-05-31 |
| Find all providers in zip 07003 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023500030 | Jeffrey D Haimson Dmd | Dentist | 1018 Broad St Ste 4, Bloomfield, NJ 07003-2884 | 2018-06-05 |
| 1134648660 | Kushan K Shah | Dentist | 2 Wintonbury Mall Ste 5, Bloomfield, CT 06002-2466 | 2017-09-15 |
| 1245583798 | Bloomfield Family Dental, PC | Dentist | 2 Wintonbury Mall # 5, Bloomfield, CT 06002-2466 | 2012-10-22 |
| 1023344181 | Sundance Dental Care of Bloomfield, LLC. | Dentist | 100 South First Street, Bloomfield, NM 87413 | 2009-10-26 |
| 1861648768 | Qiaomei Yan | Dentist | 800 Cottage Grove Rd # Set311, Bloomfield, CT 06002-3064 | 2008-08-11 |
| 1467626721 | Anthony V. Parrillo | Dentist | 171 Willard Ave, Bloomfield, NJ 07003-4800 | 2008-04-17 |
| 1457547937 | Elizabeth Sandoval | Dentist | 1025 Broad St Ste 3, Bloomfield, NJ 07003-2844 | 2007-09-19 |
| 1548463680 | Anthony Gerard Devincentis | Dentist | 1218 Broad St, Bloomfield, NJ 07003-3031 | 2007-06-07 |
| 1578684742 | Robert Lewis Adams | Dentist | 12 Carnoustie Cir., Bloomfield, CT 06002 | 2007-04-03 |
| 1720130024 | Lori A Haines | Dentist | 112 Fairfield Hill, Bloomfield, KY 40008 | 2007-01-17 |
| Find all providers in BLOOMFIELD | ||||
| City | BLOOMFIELD |
| Zip Code | 07003 |
Please comment or provide details below to improve the information on BROOKSIDE FAMILY DENTAL CORP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.