Organization Active NPI

Marina Kipnis DDS. PC

  • Dental Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1407004468
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
042510 Issued in NY
Legal business name
MARINA KIPNIS DDS. PC
Practice address
2110 Bath Ave
Brooklyn, NY 11214-4908
Phone
(718) 265-5525
Fax
(718) 265-1800
NPI assigned
Sep 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Authorized official

Name
Dr. Marina KipnisNPI 1982693230
Title
Dentist
Phone
(718) 265-5525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 042510 NY Primary

Addresses

Primary practice location

2110 Bath Ave
Brooklyn, NY 11214-4908

Mailing address

2110 Bath Ave
Brooklyn, NY 11214-4908
Phone (718) 265-5525

Other identifiers 1

IdentifierTypeStateIssuer
01161311MedicaidNY

National Provider Directory

National Provider Directory

Locations

2110 Bath Ave
Brooklyn, NY 11214
Phone (202) 460-4769

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1407004468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 BATH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144908",
            "telephone_number": "718-265-5525",
            "fax_number": "718-265-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 BATH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144908",
            "telephone_number": "718-265-5525",
            "fax_number": "718-265-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA KIPNIS DDS. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "KIPNIS",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "718-265-5525",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "042510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01161311",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.