Individual provider Active NPI

Mariya Malin, D.D.S

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1306055819
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12683 Issued in CT
Practice address
2250 86TH St
2ND Floor
Brooklyn, NY 11214-4139
Phone
(718) 372-2800
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 053295 NY
General Practice Dentistry 1223G0001X 12683 CT Primary

Addresses

Primary practice location

2250 86TH St
2ND Floor
Brooklyn, NY 11214-4139

Mailing address

15 Old Ridgefield Rd
Wilton, CT 06897-3013
Phone (203) 762-9907

Other identifiers 1

IdentifierTypeStateIssuer
03034975MedicaidNY

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
I20150623001520 NY Order and Referring Only - DentistPractitioner - Dentist 1456662097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12683CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Dentist, PC CurrentSince Aug 3, 2025 Accepting new patients
Wilton Smiles Associates PC CurrentSince Aug 3, 2025 Accepting new patients
Fairfield Smiles PC Current Accepting new patients

Locations

15 Old Ridgefield Rd
Wilton, CT 06897
Phone (203) 762-9907

2250 86th St
Fl 2
Brooklyn, NY 11214
Phone (718) 372-2800

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1306055819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 OLD RIDGEFIELD RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068973013",
            "telephone_number": "203-762-9907",
            "fax_number": "203-762-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 86TH ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144139",
            "telephone_number": "718-372-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIN",
        "first_name": "MARIYA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "053295",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "12683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03034975",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.