Individual provider Active NPI

Solomon Grinberg, D.D.S

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1447322979
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
034052 Issued in NY
Practice address
1414 Avenue P
Brooklyn, NY 11229-1110
Phone
(718) 382-6111
Fax
(718) 382-6245
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 034052 NY Primary

Addresses

Primary practice location

1414 Avenue P
Brooklyn, NY 11229-1110

Mailing address

1414 Ave P
Brooklyn, NY 11229
Phone (718) 382-6111

Other identifiers 1

IdentifierTypeStateIssuer
00346043MedicaidNY

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
034052NYMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447322979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 AVE P",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11229",
            "telephone_number": "718-382-6111",
            "fax_number": "718-382-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 AVENUE P",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291110",
            "telephone_number": "718-382-6111",
            "fax_number": "718-382-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINBERG",
        "first_name": "SOLOMON",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "034052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00346043",
            "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 Jul 8, 2007; 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.