Individual provider Active NPI

Rachel Iospa, DMD

  • Pediatric Dentistry
  • Staten Island, NY
National Provider Identifier
1003054370
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
054140 Issued in NY
Practice address
39 Heinz Ave
Staten Island, NY 10308-3329
Phone
(347) 782-1889
NPI assigned
Jan 26, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 054140 NY Primary

Addresses

Primary practice location

39 Heinz Ave
Staten Island, NY 10308-3329

Mailing address

39 Heinz Ave
Staten Island, NY 10308-3329
Phone (347) 782-1889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251007002244 NY Practitioner - Dentist 4688171671

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054140NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
White Hall Dental, PC Pediatric Dentistry CurrentSince Jul 20, 2025 Accepting new patients

Locations

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

Organizations & group practices 1

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": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1003054370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 HEINZ AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103083329",
            "telephone_number": "347-782-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 HEINZ AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103083329",
            "telephone_number": "347-782-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IOSPA",
        "first_name": "RACHEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-26",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "054140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.