Individual provider Active NPI

Edward Gorodinsky, D.D.S

  • Dentist
  • Lindenhurst, NY
National Provider Identifier
1457574824
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
048202-1 Issued in NY
Practice address
191 W Hoffman Ave
Lindenhurst, NY 11757-4036
Phone
(631) 226-2333
Fax
(631) 226-2386
NPI assigned
Apr 11, 2007
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
Dentist 122300000X 048202-1 NY Primary

Addresses

Primary practice location

191 W Hoffman Ave
Lindenhurst, NY 11757-4036

Mailing address

3901 Nostrand Ave Apt 3S
Brooklyn, NY 11235-2118
Phone (917) 364-9724

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
048202-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lindenhurst Dental Associates Past 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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457574824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 NOSTRAND AVE APT 3S",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352118",
            "telephone_number": "917-364-9724",
            "fax_number": "631-226-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 W HOFFMAN AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117574036",
            "telephone_number": "631-226-2333",
            "fax_number": "631-226-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORODINSKY",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "048202-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, 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.