Individual provider Active NPI

Geniretta Arakelova, DDS

  • General Practice Dentistry
  • Boca Raton, FL
National Provider Identifier
1003879255
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN23195 Issued in FL
Practice address
21312 Saint Andrews Blvd
Boca Raton, FL 33433-2432
Phone
(718) 801-2151
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 050970 NY
General Practice Dentistry 1223G0001X DN23195 FL Primary

Addresses

Primary practice location

21312 Saint Andrews Blvd
Boca Raton, FL 33433-2432

Mailing address

21438 St.Andrews Grand Circle
Boca Raton, FL 33486
Phone (718) 801-2151

Other identifiers 1

IdentifierTypeStateIssuer
02553973MedicaidNY

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
DN23195FLMDGeneral Practice Dentistry
050970NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1003879255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21438 ST.ANDREWS GRAND CIRCLE",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33486",
            "telephone_number": "718-801-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21312 SAINT ANDREWS BLVD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334332432",
            "telephone_number": "718-801-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARAKELOVA",
        "first_name": "GENIRETTA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050970",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02553973",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.