Individual provider Active NPI

Paul Wertenteil

  • Dentist
  • Staten Island, NY
National Provider Identifier
1124827084
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
064520 Issued in NY
Practice address
439 Port Richmond Ave
Staten Island, NY 10302-1714
Phone
(718) 924-2254
Fax
(718) 442-0189
NPI assigned
Mar 12, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 064520 NY Primary

Addresses

Primary practice location

439 Port Richmond Ave
Staten Island, NY 10302-1714

Mailing address

991 Dartmouth LN
Woodmere, NY 11598-1009

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
064520NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Richmond, Inc PastSince Jun 15, 2025 Accepting new patients
Community Health Center of Richmond Inc PastSince Jun 15, 2025 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GBJJAA

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": "1741737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1124827084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 DARTMOUTH LN",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 PORT RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021714",
            "telephone_number": "718-924-2254",
            "fax_number": "718-442-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERTENTEIL",
        "first_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-12",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "064520",
            "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 Jun 11, 2025; 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.