Active NPI
Jennifer Corredor, DDS
- Dentist
- Whitestone, NY
National Provider Identifier
1164864484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0567551
- Practice address
- 1446 139TH St
Whitestone, NY 11357-2338 - Phone
- (718) 216-3855
- NPI assigned
- Jul 28, 2013
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 0567551 | NY | Primary |
Addresses
Primary practice location
1446 139TH St
Whitestone, NY 11357-2338
Mailing address
1446 139TH St
Whitestone, NY 11357-2338
Phone (718) 216-3855
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 |
|---|---|---|---|
| 0567551 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374969600000",
"number": "1164864484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1446 139TH ST",
"city": "WHITESTONE",
"state": "NY",
"postal_code": "113572338",
"telephone_number": "718-216-3855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1446 139TH ST",
"city": "WHITESTONE",
"state": "NY",
"postal_code": "113572338",
"telephone_number": "718-216-3855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORREDOR",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-28",
"last_updated": "2013-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "0567551",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whitestone, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.