Active NPI
Michael I. Katayev, DDS
- General Practice Dentistry
- New York, NY
National Provider Identifier
1285843425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 052850
- Practice address
- 300 E 40TH St Ste B
New York, NY 10016-2188 - Phone
- (212) 905-0081
- Fax
- (212) 905-0084
- NPI assigned
- May 22, 2007
- Last updated
- Oct 5, 2020
- 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 | 052850 | NY | |
| General Practice Dentistry | 1223G0001X | 052850 | NY | Primary |
Addresses
Primary practice location
300 E 40TH St Ste B
New York, NY 10016-2188
Mailing address
300 E 40TH St Ste B
New York, NY 10016-2188
Phone (212) 905-0081
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 205319722 | Other | NY | TAX ID |
| 02771566 | Medicaid | NY |
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 |
|---|---|---|---|
| 052850 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Winston Dental, LLC | General Practice | Past | Accepting new patients |
| Michael I Katayev DDS.,PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Rego Park, NY
- NPI 1720253545
-
- General Practice Dentistry
- New York, NY
- NPI 1356714968
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601856000000",
"number": "1285843425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E 40TH ST STE B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100162188",
"telephone_number": "212-905-0081",
"fax_number": "212-905-0084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E 40TH ST STE B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100162188",
"telephone_number": "212-905-0081",
"fax_number": "212-905-0084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATAYEV",
"first_name": "MICHAEL",
"middle_name": "I.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2020-10-05",
"certification_date": "2020-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "052850",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "052850",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "205319722",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02771566",
"state": "NY"
}
],
"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 Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.