Individual provider Active NPI

Olga Miriam Iglesias, DDS

  • General Practice Dentistry
  • Blauvelt, NY
National Provider Identifier
1154475325
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
051399 Issued in NY
Practice address
294 Greenbush Rd
Blauvelt, NY 10913-1933
Phone
(845) 613-7913
NPI assigned
Jan 23, 2007
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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 051399 NY Primary

Addresses

Primary practice location

294 Greenbush Rd
Blauvelt, NY 10913-1933

Mailing address

27830 Quiet Sky Place Dr
Spring, TX 77386-4108
Phone (718) 614-0328

Other identifiers 1

IdentifierTypeStateIssuer
02561306MedicaidNY

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ske Root Canal Specialists,Inc Current Accepting new patients
Igdental,P.C. Past Accepting new patients

Locations

6078 FM 2920 Rd
Spring, TX 77379
Phone (281) 516-8049

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1154475325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27830 QUIET SKY PLACE DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773864108",
            "telephone_number": "718-614-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 GREENBUSH RD",
            "city": "BLAUVELT",
            "state": "NY",
            "postal_code": "109131933",
            "telephone_number": "845-613-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGLESIAS",
        "first_name": "OLGA",
        "middle_name": "MIRIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "051399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02561306",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blauvelt, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.