Individual provider Active NPI

Jonnathan Charles Figueroa, DMD

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1366766354
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
54568 Issued in NY
Practice address
645 10TH Ave
New York, NY 10036-2904
Phone
(212) 749-1820
NPI assigned
Mar 18, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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 58830 CA
General Practice Dentistry 1223G0001X 54568 NY Primary

Addresses

Primary practice location

645 10TH Ave
New York, NY 10036-2904

Mailing address

645 10TH Ave
New York, NY 10036-2904
Phone (212) 749-1820

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
I20151203002824 NY Practitioner - DentistPractitioner - Oral Surgery 5890095475 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54568NYMDGeneral Practice Dentistry
054568NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
William F Ryan Community Health Center Inc CurrentSince Sep 30, 2015 Accepting new patients
Ryan-Chelsea Clinton Community Health Center CurrentSince Oct 14, 2023 Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Sep 30, 2015 Accepting new patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc CurrentSince Jan 27, 2020 Accepting new patients
Sun River Health Inc. CurrentSince Jan 27, 2020 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

6 Henry St
Beacon, NY 12508
Phone (845) 831-0400

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

645 10th Ave
New York, NY 10036
Phone (212) 265-4500

110 W 97th St
#0
New York, NY 10025

279 E 3rd St
New York, NY 10009
Phone (212) 477-8500

Organizations & group practices 6

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": "1268870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1366766354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100362904",
            "telephone_number": "212-749-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100362904",
            "telephone_number": "212-749-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIGUEROA",
        "first_name": "JONNATHAN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-18",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58830",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "54568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.