Active NPI
Dino Moundroukas, DDS
- Dentist
- Scarsdale, NY
National Provider Identifier
1235278003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 045874
- Practice address
- 601 Central Park Ave
Scarsdale, NY 10583 - Phone
- (914) 722-4001
- NPI assigned
- Feb 6, 2007
- Last updated
- Mar 24, 2016
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 045874 | NY | Primary |
Addresses
Primary practice location
601 Central Park Ave
Scarsdale, NY 10583
Mailing address
601 Central Park Ave
Scarsdale, NY 10583
Phone (914) 722-4001
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 |
|---|---|---|---|---|
| I20160420000623 | NY | Order and Referring Only - Dentist | 5799721767 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wihd Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458777600000",
"number": "1235278003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 CENTRAL PARK AVE",
"city": "SCARSDALE",
"state": "NY",
"postal_code": "10583",
"telephone_number": "914-722-4001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 CENTRAL PARK AVE",
"city": "SCARSDALE",
"state": "NY",
"postal_code": "10583",
"telephone_number": "914-722-4001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUNDROUKAS",
"first_name": "DINO",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-06",
"last_updated": "2016-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "045874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Scarsdale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; 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.