Individual provider Active NPI

Ted Tatsushi Uotani, DMD

  • Pediatric Dentistry
  • New York, NY
National Provider Identifier
1336606144
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
061282 Issued in NY
Practice address
506 Lenox Ave
New York, NY 10037-1889
Phone
(212) 939-2848
NPI assigned
Feb 28, 2019
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 061282 NY Primary

Addresses

Primary practice location

506 Lenox Ave
New York, NY 10037-1889

Mailing address

227 E 86TH St Apt 3C
New York, NY 10028-3114
Phone (832) 212-6155

Other practice location 1

2155 86th St
Brooklyn, NY 11214-3205
Phone (718) 509-4888

Other practice location 2

6321 18th Ave
Brooklyn, NY 11204-2941
Phone (718) 397-1110

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
I20240520002161 NY Practitioner - Dentist 7214266790 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
061282NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Harlem Medical Associates PC CurrentSince Mar 26, 2024 Accepting new patients
86 Street Dental PC Pediatric Dentistry PastSince Jan 14, 2024 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Interoperability endpoints

  • Direct secure messaging: tuotani4022245@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, 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": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1336606144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 E 86TH ST APT 3C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100283114",
            "telephone_number": "832-212-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 LENOX AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371889",
            "telephone_number": "212-939-2848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2155 86th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112143205",
            "country_code": "US",
            "telephone_number": "718-509-4888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6321 18th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112042941",
            "country_code": "US",
            "telephone_number": "718-397-1110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UOTANI",
        "first_name": "TED",
        "middle_name": "TATSUSHI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-28",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "061282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.