Individual provider Active NPI

Gabriel Bogdan Ionescu, DDS

  • Dentist
  • Long Island City, NY
National Provider Identifier
1184823122
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
043705 Issued in NY
Practice address
41-11 Queens Blvd
Long Island City, NY 11104
Phone
(718) 784-0110
Fax
(718) 784-0110
NPI assigned
Jul 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 043705 NY Primary

Addresses

Primary practice location

41-11 Queens Blvd
Long Island City, NY 11104

Mailing address

41-11 Queens Blvd
Main Floor
Long Island City, NY 11104
Phone (718) 784-0110

Other identifiers 2

IdentifierTypeStateIssuer
01274455MedicaidNY
043705OtherNYNYU

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
043705NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1184823122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41-11 QUEENS BLVD",
            "address_2": "MAIN FLOOR",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "11104",
            "telephone_number": "718-784-0110",
            "fax_number": "718-784-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41-11 QUEENS BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "11104",
            "telephone_number": "718-784-0110",
            "fax_number": "718-784-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IONESCU",
        "first_name": "GABRIEL",
        "middle_name": "BOGDAN",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "043705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01274455",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYU",
            "identifier": "043705",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.