Individual provider Active NPI

Grigoriy Gelfand, DDS

  • General Practice Dentistry
  • Flushing, NY
National Provider Identifier
1437574050
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
058030 Issued in NY
Practice address
3530 Francis Lewis Blvd
Suite 203
Flushing, NY 11358-1931
Phone
(718) 461-0100
NPI assigned
Feb 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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 058030 NY Primary

Addresses

Primary practice location

3530 Francis Lewis Blvd
Suite 203
Flushing, NY 11358-1931

Mailing address

3530 Francis Lewis Blvd
Suite 203
Flushing, NY 11358-1931
Phone (917) 841-9916

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
I20160427001382 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6709185697

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
058030NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gentle Dental World, P.C. PastSince Jul 24, 2022 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": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1437574050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 FRANCIS LEWIS BLVD",
            "address_2": "SUITE 203",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581931",
            "telephone_number": "917-841-9916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 FRANCIS LEWIS BLVD",
            "address_2": "SUITE 203",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581931",
            "telephone_number": "718-461-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELFAND",
        "first_name": "GRIGORIY",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-19",
        "last_updated": "2015-07-29",
        "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": "058030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.