Individual provider Active NPI

Carlos Miranda, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1295948610
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
049054 Issued in NY
Practice address
21 Sherman Ave
New York, NY 10040-1815
Phone
(212) 569-3114
Fax
(212) 569-2118
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 049054 NY Primary

Addresses

Primary practice location

21 Sherman Ave
New York, NY 10040-1815

Mailing address

21 Sherman Ave
New York, NY 10040-1815
Phone (212) 569-3114

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230406002248 NY Practitioner - Dentist 8527335389 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Dec 31, 2022 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Dec 31, 2022 Accepting new patients

Locations

2094 Pitkin Ave
Brooklyn, NY 11207
Phone (718) 240-0400

50 Water St
Fl 3
New York, NY 10004

227 Madison St
New York, NY 10002
Phone (212) 238-7000

227 Madison St
Fl First
New York, NY 10002
Phone (212) 238-7071

264 W 118th St
New York, NY 10026
Phone (212) 932-6500

Interoperability endpoints

  • Direct secure messaging: cmirandapagan679586@nychhc.direct-ci.com

Organizations & group practices 3

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295948610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SHERMAN AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401815",
            "telephone_number": "212-569-3114",
            "fax_number": "212-569-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SHERMAN AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401815",
            "telephone_number": "212-569-3114",
            "fax_number": "212-569-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.