Individual provider Active NPI

Wendy Goldberg Miles, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1063751626
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
040796 Issued in NY
Practice address
200 W 57TH St
Suite 808
New York, NY 10019-3211
Phone
(212) 586-2997
NPI assigned
Feb 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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 040796 NY Primary

Addresses

Primary practice location

200 W 57TH St
Suite 808
New York, NY 10019-3211

Mailing address

200 W 57TH St
Suite 808
New York, NY 10019-3211
Phone (212) 586-2997

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
I20160614002503 NY Order and Referring Only - DentistPractitioner - Dentist 9234420613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040796NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1063751626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 57TH ST",
            "address_2": "SUITE 808",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193211",
            "telephone_number": "212-586-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 57TH ST",
            "address_2": "SUITE 808",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193211",
            "telephone_number": "212-586-2997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "WENDY",
        "middle_name": "GOLDBERG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-01",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.