Individual provider Active NPI

Daniel Marc Katz

  • General Practice Dentistry
  • Middletown, NY
National Provider Identifier
1205457744
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
06187901 Issued in NY
Practice address
674 E Main St
Middletown, NY 10940-2644
Phone
(845) 343-1486
NPI assigned
May 6, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 06187901 NY Primary

Addresses

Primary practice location

674 E Main St
Middletown, NY 10940-2644

Mailing address

250 W 89TH St # 3C
New York, NY 10024-1700
Phone (516) 509-2127

Other practice location 1

201 Lyons Ave
Newark, NJ 07112-2027
Phone (973) 926-7642

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
06187901NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1205457744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 89TH ST # 3C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100241700",
            "telephone_number": "516-509-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "674 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402644",
            "telephone_number": "845-343-1486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Lyons Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071122027",
            "country_code": "US",
            "telephone_number": "973-926-7642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KATZ",
        "first_name": "DANIEL",
        "middle_name": "MARC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-06",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "06187901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.