Maria Supnet Gozun, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

048541-1 Issued in NY

Practice address

9876 Queens Blvd
Ste. P-1
Rego Park, NY 11374-4356

Phone

(718) 897-3400

Fax

(718) 897-3401

NPI assigned

Dec 23, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 9, 2016 through Feb 9, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393372800000",
    "number": "1225367188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9876 QUEENS BLVD",
            "address_2": "STE. P-1",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744398",
            "telephone_number": "718-897-3400",
            "fax_number": "718-897-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9876 QUEENS BLVD",
            "address_2": "STE. P-1",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744356",
            "telephone_number": "718-897-3400",
            "fax_number": "718-897-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOZUN",
        "first_name": "MARIA",
        "middle_name": "SUPNET",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-23",
        "last_updated": "2014-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048541-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Goodman, LCSW
• Krystal-Ann Gopichand
• Jessica Nicole Gordon
• Maryann Gorman, RD
• Christopher Gozun, DDS
• Grace Wang NP in Family Health P.C.
• Vanessa Graham, MSED
• Melie Graves, MHA, RD, CDN
• Sheana Green
• Tatiana Green, CASAC-2

• General Practice Dentistry in Rego Park, NY
• Providers in Rego Park, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.