Individual provider Active NPI

Inna Gellerman, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Huntington, NY
National Provider Identifier
1053412387
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
048684-1 Issued in NY
Practice address
165 Main St
Huntington, NY 11743-3570
Phone
(631) 427-8444
Fax
(631) 470-7837
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 048684-1 NY Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DI02165200 NJ
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DI02165201 NJ

Addresses

Primary practice location

165 Main St
Huntington, NY 11743-3570

Mailing address

165 Main St
Huntington, NY 11743-3570
Phone (631) 427-8444

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
DI02165200NJMDOrthodontics and Dentofacial Orthopedic Dentist
DI02165201NJMDOrthodontics and Dentofacial Orthopedic Dentist
048684-1NYMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Gellerman Orthodontics,PC Orthodontics and Dentofacial Orthopedics 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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1053412387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433570",
            "telephone_number": "631-427-8444",
            "fax_number": "631-470-7837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433570",
            "telephone_number": "631-427-8444",
            "fax_number": "631-470-7837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELLERMAN",
        "first_name": "INNA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "048684-1",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "DI02165200",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "DI02165201",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; 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.