Individual provider Active NPI

Doris Nelly Ladino, DDS

  • Dentist
  • Jackson Heights, NY
National Provider Identifier
1043438880
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
048850 Issued in NY
Practice address
37-12 90TH St
Jackson Heights, NY 11372
Phone
(718) 429-5550
Fax
(718) 429-5556
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 048850 NY Primary

Addresses

Primary practice location

37-12 90TH St
Jackson Heights, NY 11372

Mailing address

3712 90TH St
Jackson Heights, NY 11372-7862
Phone (718) 429-5550

Other identifiers 1

IdentifierTypeStateIssuer
02084655MedicaidNY

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
048850NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bella Smile Dental 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.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1043438880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3712 90TH ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727862",
            "telephone_number": "718-429-5550",
            "fax_number": "718-429-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37-12 90TH ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "11372",
            "telephone_number": "718-429-5550",
            "fax_number": "718-429-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADINO",
        "first_name": "DORIS",
        "middle_name": "NELLY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "048850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02084655",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.