Individual provider Active NPI

Rebecca Pauline Gutowski, DMD

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1194349779
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
062132 Issued in NY
Practice address
160 Broadway RM 1004
New York, NY 10038-4213
Phone
(212) 287-1275
NPI assigned
May 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 062132 NY
General Practice Dentistry 1223G0001X 062132 NY Primary

Addresses

Primary practice location

160 Broadway RM 1004
New York, NY 10038-4213

Mailing address

380 Union Ave
Brooklyn, NY 11211-3429
Phone (718) 736-2149

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
062132NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lumia Dental, PLLC Dentist CurrentSince Feb 4, 2024 Accepting new patients

Locations

160 Broadway
Rm 1004
New York, NY 10038
Phone (212) 287-1275

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": "1590796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1194349779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 UNION AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112113429",
            "telephone_number": "718-736-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BROADWAY RM 1004",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384213",
            "telephone_number": "212-287-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTOWSKI",
        "first_name": "REBECCA",
        "middle_name": "PAULINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-30",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062132",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "062132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.