Active NPI
Mindy A Podos-Bader, D.D.S.
- Dentist
- Monroe, NY
National Provider Identifier
1033354642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 039745
- Practice address
- 845 State Route 17M
Suite 201
Monroe, NY 10950-1606 - Phone
- (845) 782-8686
- Fax
- (845) 783-8457
- NPI assigned
- Dec 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 039745 | NY | Primary |
Addresses
Primary practice location
845 State Route 17M
Suite 201
Monroe, NY 10950-1606
Mailing address
845 State Route 17M
Suite 201
Monroe, NY 10950-1606
Phone (845) 782-8686
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
| License | State | Type | Specialty |
|---|---|---|---|
| 039745 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simply Dental of Monroe, PLLC | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Monroe, NY
- NPI 1871702159
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228867200000",
"number": "1033354642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "845 STATE ROUTE 17M",
"address_2": "SUITE 201",
"city": "MONROE",
"state": "NY",
"postal_code": "109501606",
"telephone_number": "845-782-8686",
"fax_number": "845-783-8457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "845 STATE ROUTE 17M",
"address_2": "SUITE 201",
"city": "MONROE",
"state": "NY",
"postal_code": "109501606",
"telephone_number": "845-782-8686",
"fax_number": "845-783-8457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PODOS-BADER",
"first_name": "MINDY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-10",
"last_updated": "2008-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "039745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.