Individual provider Active NPI

Beniamin Ifraimov, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1124045166
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
050668 Issued in NY
Practice address
209 E 56TH St
Ground Floor
New York, NY 10022-3705
Phone
(212) 355-2290
Fax
(212) 355-2379
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 050668 NY Primary

Addresses

Primary practice location

209 E 56TH St
Ground Floor
New York, NY 10022-3705

Mailing address

2028 E 21St St
Brooklyn, NY 11229-3626
Phone (718) 614-0447

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
050668NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
209 Nyc Dental LLP General Practice Past Accepting new patients
Kafko, Kaminsky, & Kaufman DDS, LLP General Practice 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.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124045166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 E 21ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293626",
            "telephone_number": "718-614-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 E 56TH ST",
            "address_2": "GROUND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223705",
            "telephone_number": "212-355-2290",
            "fax_number": "212-355-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFRAIMOV",
        "first_name": "BENIAMIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.