Active NPI
Kathrin Charlotte Praedikow, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- New York, NY
National Provider Identifier
1124621891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 060293-1
- Practice address
- 133 E 58TH St Ste 912
New York, NY 10022-1283 - Phone
- (212) 207-8028
- NPI assigned
- Nov 17, 2020
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 060293-1 | NY | Primary |
Addresses
Primary practice location
133 E 58TH St Ste 912
New York, NY 10022-1283
Mailing address
148 Old Stump Rd
Brookhaven, NY 11719-9689
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | kp878@nyu.edu |
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 |
|---|---|---|---|
| 060293-1 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1124621891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 OLD STUMP RD",
"city": "BROOKHAVEN",
"state": "NY",
"postal_code": "117199689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 E 58TH ST STE 912",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100221283",
"telephone_number": "212-207-8028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRAEDIKOW",
"first_name": "KATHRIN",
"middle_name": "CHARLOTTE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-17",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "060293-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "kp878@nyu.edu",
"affiliation": "N",
"address_1": "133 E 58th St Ste 912",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100221283",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.