Individual provider Active NPI

Marina Fainberg, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1174755193
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50 054703 Issued in NY
Practice address
6317 4TH Ave
Dental Dept.
Brooklyn, NY 11220-4922
Phone
(718) 907-8100
Fax
(718) 492-8544
NPI assigned
Aug 10, 2009
Last updated
Dec 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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 50 054703 NY Primary

Addresses

Primary practice location

6317 4TH Ave
Dental Dept.
Brooklyn, NY 11220-4922

Mailing address

6317 4TH Ave
Dental Dept.
Brooklyn, NY 11220-4922
Phone (718) 907-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160420002407 NY Order and Referring Only - DentistPractitioner - Dentist 0749588960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50 054703NYMDGeneral Practice Dentistry
054703NYMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: mfainberg133285@nyumc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1174755193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6317 4TH AVE",
            "address_2": "DENTAL DEPT.",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204922",
            "telephone_number": "718-907-8100",
            "fax_number": "718-492-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6317 4TH AVE",
            "address_2": "DENTAL DEPT.",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204922",
            "telephone_number": "718-907-8100",
            "fax_number": "718-492-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAINBERG",
        "first_name": "MARINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "50 054703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.