Individual provider Active NPI

Drumilkumar L Yagnik, D.D.S

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1174679336
Registry record updated Aug 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
038073 Issued in NY
Practice address
4446 Broadway
New York, NY 10040-2939
Phone
(212) 567-1010
NPI assigned
Jan 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2016

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 038073 NY Primary

Addresses

Primary practice location

4446 Broadway
New York, NY 10040-2939

Mailing address

225 US Highway 46
Ste 10
Totowa, NJ 07512-1814
Phone (973) 890-8811

Other identifiers 1

IdentifierTypeStateIssuer
00810004MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160829000525 NJ Order and Referring Only - DentistPractitioner - Dentist 4082909122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038073NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
46 Dental, PC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471737600000",
    "number": "1174679336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 US HIGHWAY 46",
            "address_2": "STE 10",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075121814",
            "telephone_number": "973-890-8811",
            "fax_number": "973-890-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4446 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100402939",
            "telephone_number": "212-567-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGNIK",
        "first_name": "DRUMILKUMAR",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-28",
        "last_updated": "2016-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "038073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00810004",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.