Individual provider Active NPI

Dmitry Epelboym, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1003007543
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
045076-1 Issued in NY
Practice address
7708 4TH Ave
Brooklyn, NY 11209-3402
Phone
(718) 491-3100
Fax
(718) 491-2140
NPI assigned
Aug 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 045076-1 NY Primary

Addresses

Primary practice location

7708 4TH Ave
Brooklyn, NY 11209-3402

Mailing address

7708 4TH Ave
Brooklyn, NY 11209-3402
Phone (718) 491-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
045076-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
DBM Management Corp General Practice Past Accepting new patients
Beam a Smile Dental PLLC General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1003007543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7708 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093402",
            "telephone_number": "718-491-3100",
            "fax_number": "718-491-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7708 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093402",
            "telephone_number": "718-491-3100",
            "fax_number": "718-491-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPELBOYM",
        "first_name": "DMITRY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045076-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.