Individual provider Active NPI

Esther Gellis- Gottlieb, DDS

  • General Practice Dentistry
  • Lynbrook, NY
National Provider Identifier
1407268212
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
058044 Issued in NY
Practice address
96 Atlantic Ave
Lynbrook, NY 11563-3461
Phone
(516) 792-6952
NPI assigned
May 28, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 058044 NY Primary

Addresses

Primary practice location

96 Atlantic Ave
Lynbrook, NY 11563-3461

Mailing address

141 Elm St
Woodmere, NY 11598-2617
Phone (516) 569-4130

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
I20230307003406 NY Practitioner - Dentist 0941673230 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hasc Diagnostic & Treatment Center, Inc CurrentSince Nov 30, 2022 Accepting new patients
Hasc Diagnostic &Treatment Center, Inc CurrentSince Nov 30, 2022 Accepting new patients
Atlantic Ave Dental Care General Practice Past Accepting new patients
Atlantic Avenue Dental PC General Practice Past Accepting new patients

Locations

1221 E 14th St
Brooklyn, NY 11230
Phone (718) 434-4600

5601 1st Ave
Brooklyn, NY 11220
Phone (718) 650-0110

Organizations & group practices 4

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": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407268212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 ELM ST",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115982617",
            "telephone_number": "516-569-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 ATLANTIC AVE",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115633461",
            "telephone_number": "516-792-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELLIS- GOTTLIEB",
        "first_name": "ESTHER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynbrook, NY

Sources for this page

Verify at the official NPI Registry.