Mitchell Teitelbaum, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

040191 Issued in NY

Practice address

48 Gramercy Park North
New York, NY 10010

Phone

(212) 674-6988

Fax

(718) 853-2110

NPI assigned

Mar 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: mitchell.teitelbaumdds.p1@direct.ezramedical.nextgenshare.com

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093839706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 GRAMERCY PARK NORTH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10010",
            "telephone_number": "212-674-6988",
            "fax_number": "718-853-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 GRAMERCY PARK NORTH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10010",
            "telephone_number": "212-674-6988",
            "fax_number": "718-853-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEITELBAUM",
        "first_name": "MITCHELL",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "040191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00978161",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael G Teitel, MD
• Rachel Megan Teitel, LCSW-R
• Alan R Teitelbaum, DPM
• Ezra Teitelbaum, DSW, LCSW
• Jill Teitelbaum, MD
• Stanley H Teitelbaum
• Stefanie C. Teitelbaum, LSCW
• Michael Teitelman, M.D.
• Juli Teitler, LCAT
• Brina Teitz

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.