Individual provider Active NPI

Robert George Veligdan

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1134325335
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
031841 Issued in NY
Practice address
635 Madison Ave
New York, NY 10022-1009
Phone
(212) 832-2330
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
Yes

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 031841 NY Primary

Addresses

Primary practice location

635 Madison Ave
New York, NY 10022-1009

Mailing address

635 Madison Ave
New York, NY 10022-1009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective May 12, 2016 through May 12, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
031841NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134325335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221009",
            "telephone_number": "212-832-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELIGDAN",
        "first_name": "ROBERT",
        "middle_name": "GEORGE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "031841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.