Stephanie Gomez

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

061191-01 Issued in NY

Practice address

22 N Division St
Peekskill, NY 10566-2944

Phone

(917) 557-1465

NPI assigned

Jun 3, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Union Community Health Center, Inc.

  • Clinic/Center
  • Bronx, NY
  • NPI 1437255155
  Medicare reassignment NPD
• Dentistry for Children at Peekskill PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Peekskill, NY
  • NPI 1912576398
  NPD Authorized official

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1316505530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 N DIVISION ST",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105662944",
            "telephone_number": "914-630-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 N DIVISION ST",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105662944",
            "telephone_number": "917-557-1465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107014006",
            "country_code": "US",
            "telephone_number": "917-557-1465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2023-12-05",
        "certification_date": "2023-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "061191-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlyn Godbee
• Gold Star Day Care Inc.
• Carol D. Gold, ANP
• Lisa J Golden, LPN
• Jonathan Goldwasser, LMSW
• Luz Maria Gonzalez
• Jennifer G. Goodale, D.D.S.
• Donette V. Gordon-Senior
• Christine Gordon
• Marian Christine Gore, C.M.

• Pediatric Dentistry in Peekskill, NY
• Providers in Peekskill, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.