Active NPI
Dennis W Peng, DDS
- General Practice Dentistry
- Ny, NY
National Provider Identifier
1205855152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 041043
- Practice address
- 280 Henry St
Betances Health Center
Ny, NY 10002 - Phone
- (212) 227-8401
- Fax
- (212) 227-8842
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 041043 | NY | Primary |
Addresses
Primary practice location
280 Henry St
Betances Health Center
Ny, NY 10002
Mailing address
280 Henry St
Betances Health Center
Ny, NY 10002
Phone (212) 227-8401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160428001156 | NY | Order and Referring Only - Other (Physician) | 6709185564 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041043 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487116800000",
"number": "1205855152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 HENRY ST",
"address_2": "BETANCES HEALTH CENTER",
"city": "NY",
"state": "NY",
"postal_code": "10002",
"telephone_number": "212-227-8401",
"fax_number": "212-227-8842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 HENRY ST",
"address_2": "BETANCES HEALTH CENTER",
"city": "NY",
"state": "NY",
"postal_code": "10002",
"telephone_number": "212-227-8401",
"fax_number": "212-227-8842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENG",
"first_name": "DENNIS",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2017-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "041043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ny, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.