Individual provider Active NPI

Taryn Katz

  • Pediatric Dentistry
  • Valley Stream, NY
National Provider Identifier
1083955371
Registry record updated Mar 5, 2019
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Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
058014 Issued in NY
Practice address
509 W Merrick Rd
#103
Valley Stream, NY 11580-5252
Phone
(516) 561-1151
NPI assigned
Mar 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 058014 NY Primary

Addresses

Primary practice location

509 W Merrick Rd
#103
Valley Stream, NY 11580-5252

Mailing address

6625 103Rd St
Apt 6E
Forest Hills, NY 11375-2001
Phone (516) 395-5921

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
I20190509002716 NY Order and Referring Only - DentistPractitioner - Dentist 6204179427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1083955371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 103RD ST",
            "address_2": "APT 6E",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752001",
            "telephone_number": "516-395-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 W MERRICK RD",
            "address_2": "#103",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805252",
            "telephone_number": "516-561-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "TARYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "058014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.