Individual provider Active NPI

Merela Cruz Rieza-Concepcion, DDS

  • General Practice Dentistry
  • Binghamton, NY
National Provider Identifier
1164610770
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D18390 Issued in NJ
Practice address
289 Chenango St
Binghamton, NY 13901-2312
Phone
(607) 217-7122
NPI assigned
Oct 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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 D18390 NJ Primary

Addresses

Primary practice location

289 Chenango St
Binghamton, NY 13901-2312

Mailing address

733 Westside Ave
Jersey City, NJ 07306-6011
Phone (201) 324-1919

Other practice location 1

733 Westside Ave
Jersey City, NJ 07306-6011
Phone (201) 324-1919

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
D18390NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1164610770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 WESTSIDE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073066011",
            "telephone_number": "201-324-1919",
            "fax_number": "201-324-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 CHENANGO ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139012312",
            "telephone_number": "607-217-7122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "733 Westside Ave",
            "address_purpose": "LOCATION",
            "city": "Jersey City",
            "state": "NJ",
            "postal_code": "073066011",
            "country_code": "US",
            "telephone_number": "201-324-1919",
            "fax_number": "201-324-1605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIEZA-CONCEPCION",
        "first_name": "MERELA",
        "middle_name": "CRUZ",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "D18390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.