Individual provider Active NPI

Daudrie-Ann Powell, D.D.S.

  • Dentist
  • Bronx, NY
National Provider Identifier
1205250321
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50057125 Issued in NY
Practice address
1510 Unionport Rd
Apt 1D
Bronx, NY 10462-7853
Phone
(202) 702-1054
NPI assigned
Feb 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50057125 NY Primary

Addresses

Primary practice location

1510 Unionport Rd
Apt 1D
Bronx, NY 10462-7853

Mailing address

1510 Unionport Rd
Apt 1D
Bronx, NY 10462-7853
Phone (202) 702-1054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20150713002601 GA Order and Referring Only - DentistPractitioner - Dentist 2860705399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50057125NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1205250321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 UNIONPORT RD",
            "address_2": "APT 1D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104627853",
            "telephone_number": "202-702-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 UNIONPORT RD",
            "address_2": "APT 1D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104627853",
            "telephone_number": "202-702-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "DAUDRIE-ANN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-10",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "50057125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.