Individual provider Active NPI

Marina Podlubny, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1023280690
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
047443-1 Issued in NY
Practice address
3768 Broadway
New York, NY 10032-1548
Phone
(212) 234-2244
Fax
(212) 281-3789
NPI assigned
Mar 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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 047443-1 NY Primary

Addresses

Primary practice location

3768 Broadway
New York, NY 10032-1548

Mailing address

3768 Broadway
New York, NY 10032-1548
Phone (212) 234-2244

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
I20230301000653 NY Practitioner - DentistPractitioner - Oral Surgery 0547571820 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047443-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
43 Chruch Street Dental PC CurrentSince Nov 24, 2022 Accepting new patients
Bonita Sonrisa Dental Mso CurrentSince Nov 24, 2022 Accepting new patients
Bonita Sonrisa Dental Ipa CurrentSince Nov 24, 2022 Accepting new patients
Alejandro Williams Dental Office PC CurrentSince Nov 24, 2022 Accepting new patients
3545 Johnson Blvd Dental PC CurrentSince Nov 24, 2022 Accepting new patients
Marina Dental PC Past Accepting new patients

Locations

759 4th Ave
Brooklyn, NY 11232
Phone (718) 832-1194

Organizations & group practices 6

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": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1023280690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3768 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321548",
            "telephone_number": "212-234-2244",
            "fax_number": "212-281-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3768 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321548",
            "telephone_number": "212-234-2244",
            "fax_number": "212-281-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODLUBNY",
        "first_name": "MARINA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "047443-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.