Active NPI
Randy Gulkis, D.D.S.
- Dentist
- Staten Island, NY
National Provider Identifier
1104103340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- NY35355
- Practice address
- 15 1St St
Staten Island, NY 10306-2201 - Phone
- (718) 987-5000
- Fax
- (718) 987-2879
- NPI assigned
- Nov 15, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | NY35355 | NY | Primary |
Addresses
Primary practice location
15 1St St
Staten Island, NY 10306-2201
Mailing address
15 1St St
Staten Island, NY 10306-2201
Phone (718) 987-5000
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
| License | State | Type | Specialty |
|---|---|---|---|
| NY35355 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321315200000",
"number": "1104103340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 1ST ST",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103062201",
"telephone_number": "718-987-5000",
"fax_number": "718-987-2879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 1ST ST",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103062201",
"telephone_number": "718-987-5000",
"fax_number": "718-987-2879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULKIS",
"first_name": "RANDY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-15",
"last_updated": "2011-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "NY35355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.