Active NPI
Cathy Ann Marie Mavrinac, D.D.S.
- Dentist
- New York, NY
National Provider Identifier
1447452248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 050999-1
- Practice address
- 2071 2ND Ave
New York, NY 10029-4101 - Phone
- (212) 410-6969
- Fax
- (212) 410-6989
- NPI assigned
- Jun 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 050999-1 | NY | Primary |
Addresses
Primary practice location
2071 2ND Ave
New York, NY 10029-4101
Mailing address
74 Wilson Rd
Valley Stream, NY 11581-3418
Phone (646) 508-5345
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02717077 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 050999-1 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447452248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 WILSON RD",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115813418",
"telephone_number": "646-508-5345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2071 2ND AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100294101",
"telephone_number": "212-410-6969",
"fax_number": "212-410-6989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAVRINAC",
"first_name": "CATHY",
"middle_name": "ANN MARIE",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "050999-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02717077",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, 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.