Individual provider Active NPI

Marc Kunin, D.D.S.

  • Endodontics
  • Brooklyn, NY
National Provider Identifier
1013015643
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
040386 Issued in NY
Practice address
150 55TH St
Dental Dept.
Brooklyn, NY 11220-2508
Phone
(718) 630-8248
Fax
(718) 492-5090
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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 040386 NY
Endodontics 1223E0200X 040386 NY Primary

Addresses

Primary practice location

150 55TH St
Dental Dept.
Brooklyn, NY 11220-2508

Mailing address

150 55TH St
Dental Dept.
Brooklyn, NY 11220-2508
Phone (718) 630-8248

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
I20160613001501 NY Order and Referring Only - DentistPractitioner - Dentist 8729378203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: mkunin133771@nyumc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1013015643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "address_2": "DENTAL DEPT.",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202508",
            "telephone_number": "718-630-8248",
            "fax_number": "718-492-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "address_2": "DENTAL DEPT.",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202508",
            "telephone_number": "718-630-8248",
            "fax_number": "718-492-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNIN",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040386",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "040386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.