NPIMap

Individual provider Active NPI

Dara Alexis Pfeffer, DMD

  • Dentist
  • Flushing, NY
National Provider Identifier
1336378900
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
055540 Issued in NY
Practice address
135-14 Jewel Ave
Flushing, NY 11367
Phone
(718) 997-6453
NPI assigned
Jul 4, 2009
Last updated
May 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 055540 NY Primary
Pediatric Dentistry 1223P0221X 055540 NY
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

135-14 Jewel Ave
Flushing, NY 11367

Mailing address

8 Pond Park Road
Great Neck, NY 11023
Phone (516) 972-2765

Other names 1

  • Dara Alexis Weiner Former name

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

LicenseStateTypeSpecialty
055540NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Helen Weinberg Ortho Group DDS PLLC PastSince May 17, 2020 Accepting new patients
Laser Dentistry for Children LLC Pediatric Dentistry PastSince May 17, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: daraweiner@mai.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1246665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1336378900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 POND PARK ROAD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11023",
            "telephone_number": "516-972-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135-14 JEWEL AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11367",
            "telephone_number": "718-997-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEFFER",
        "first_name": "DARA",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-04",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "055540",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "055540",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DARA",
            "last_name": "WEINER",
            "middle_name": "ALEXIS",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.

Verify at the official NPI Registry.