Individual provider Active NPI

Gedalya Rapoport, D.M.D.

  • General Practice Dentistry
  • Pomona, NY
National Provider Identifier
1114916897
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
051857 Issued in NY
Practice address
8 Medical Park Dr
Pomona, NY 10970-3516
Phone
(845) 517-2358
Fax
(845) 517-2359
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 051857 NY Primary
Dentist 122300000X 051857 NY

Addresses

Primary practice location

8 Medical Park Dr
Pomona, NY 10970-3516

Mailing address

8 Medical Park Dr
Pomona, NY 10970-3516
Phone (845) 517-2358

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

LicenseStateTypeSpecialty
051857NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1114916897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MEDICAL PARK DR",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703516",
            "telephone_number": "845-517-2358",
            "fax_number": "845-517-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MEDICAL PARK DR",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703516",
            "telephone_number": "845-517-2358",
            "fax_number": "845-517-2359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPOPORT",
        "first_name": "GEDALYA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "051857",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "051857",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.

Verify at the official NPI Registry.