Active NPI
Hanette Sabina Gomez, D.D.S
- Dentist
- Corona, NY
National Provider Identifier
1104907393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 043863
- Practice address
- 9605 40TH Road
Corona, NY 11368 - Phone
- (718) 651-7070
- Fax
- (718) 651-6559
- NPI assigned
- Oct 17, 2006
- Sex
- Female
- 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 | 043863 | NY | Primary |
Addresses
Primary practice location
9605 40TH Road
Corona, NY 11368
Mailing address
9605 40TH Road
Corona, NY 11368
Phone (718) 651-7070
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 |
|---|---|---|---|
| 043863 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hanette Gomez Dentistry PLLC | Current | Accepting new patients | |
| Clinica Dental Latina | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Howard Beach, NY
- NPI 1376131052
-
- General Practice Dentistry
- Corona, NY
- NPI 1902177843
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319673600000",
"number": "1104907393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9605 40TH ROAD",
"city": "CORONA",
"state": "NY",
"postal_code": "11368",
"telephone_number": "718-651-7070",
"fax_number": "718-651-6559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9605 40TH ROAD",
"city": "CORONA",
"state": "NY",
"postal_code": "11368",
"telephone_number": "718-651-7070",
"fax_number": "718-651-6559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "HANETTE",
"middle_name": "SABINA",
"name_prefix": "Mrs.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2011-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "043863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.