Individual provider Active NPI

Marimar Gracia, DMD

  • Dentist
  • New York, NY
National Provider Identifier
1205006335
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
053743 Issued in NY
Practice address
143 Essex St
New York, NY 10002-2336
Phone
(212) 228-2999
NPI assigned
Mar 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 053743 NY Primary

Addresses

Primary practice location

143 Essex St
New York, NY 10002-2336

Mailing address

119 Stanhope St FL 3
Brooklyn, NY 11221-3405
Phone (718) 708-7806

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
053743NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Essex Dental Office 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": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1205006335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 STANHOPE ST FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112213405",
            "telephone_number": "718-708-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 ESSEX ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100022336",
            "telephone_number": "212-228-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACIA",
        "first_name": "MARIMAR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "053743",
            "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 Mar 4, 2008; 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.