Individual provider Active NPI

Mustapha Rammal, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1366737934
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
056114 Issued in NY
Practice address
420 W 23Rd St Apt GF
New York, NY 10011-2155
Phone
(212) 929-9200
Fax
(646) 381-9720
NPI assigned
Jun 13, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 056114 NY Primary

Addresses

Primary practice location

420 W 23Rd St Apt GF
New York, NY 10011-2155

Mailing address

470 W 165TH St Apt 41
New York, NY 10032-8120
Phone (646) 748-3985

Other identifiers 1

IdentifierTypeStateIssuer
03491274MedicaidNY

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
056114NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Chelsea Dental Studio PLLC Past Accepting new patients

Organizations & group practices 1

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": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1366737934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 W 165TH ST APT 41",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100328120",
            "telephone_number": "646-748-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 23RD ST APT GF",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100112155",
            "telephone_number": "212-929-9200",
            "fax_number": "646-381-9720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMMAL",
        "first_name": "MUSTAPHA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "056114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03491274",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.