Active NPI
Aaron Matthew Soeprono, DDS
- Dentist
- New York, NY
National Provider Identifier
1275610255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 053369
- Practice address
- 20 E 46TH St
Suite 1000
New York, NY 10017-2417 - Phone
- (212) 813-0850
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 053369 | NY | Primary |
| General Practice Dentistry | 1223G0001X | 48552 | CA |
Addresses
Primary practice location
20 E 46TH St
Suite 1000
New York, NY 10017-2417
Mailing address
20 East 46TH St.
Suite 1000
New York, NY 10017
Phone (212) 813-0850
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
| License | State | Type | Specialty |
|---|---|---|---|
| 48552 | CA | MD | Pharmacist |
| 053369 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327622400000",
"number": "1275610255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 EAST 46TH ST.",
"address_2": "SUITE 1000",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10017",
"telephone_number": "212-813-0850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 E 46TH ST",
"address_2": "SUITE 1000",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100172417",
"telephone_number": "212-813-0850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOEPRONO",
"first_name": "AARON",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2012-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "053369",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "48552",
"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 Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.