Individual provider Active NPI

Rachel Marmor

  • Dentist
  • New York, NY
National Provider Identifier
1245478189
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
054509 Issued in NY
Practice address
140 W 69TH St
Apt 51
New York, NY 10023-5107
Phone
(516) 562-4525
NPI assigned
Jan 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02471000 NJ
Dentist 122300000X 054509 NY Primary
Dentist 122300000X 4665 WV
Dentist 122300000X 013595 CT
Dentist 122300000X DDS60803 CA

Addresses

Primary practice location

140 W 69TH St
Apt 51
New York, NY 10023-5107

Mailing address

140 W 69TH St
Apt 51
New York, NY 10023-5107

Other practice location 1

76 Progress Dr Ste 123
Stamford, CT 06902-3603
Phone (914) 835-6004 ext. 703

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
DDS60803CAMDDentist
013595CTMDDentist
22DI02471000NJMDDentist
054509NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Marmor Ny Dental PC Current Accepting new patients

Locations

76 Progress Dr
Ste 123
Stamford, CT 06902
Phone (833) 765-8373

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1245478189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W 69TH ST",
            "address_2": "APT 51",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W 69TH ST",
            "address_2": "APT 51",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235107",
            "telephone_number": "516-562-4525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "76 Progress Dr Ste 123",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069023603",
            "country_code": "US",
            "telephone_number": "914-835-6004 x703",
            "fax_number": "914-560-2216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARMOR",
        "first_name": "RACHEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02471000",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054509",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "4665",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "013595",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS60803",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.