Active NPI
Debra Jill Dermack, DDS
- Dentist
- New York, NY
National Provider Identifier
1457660938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 046279
- Practice address
- 50 Park Avenue
New York, NY 10016 - Phone
- (212) 683-3181
- Fax
- (212) 684-4226
- NPI assigned
- Sep 30, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 046279 | NY | Primary |
Addresses
Primary practice location
50 Park Avenue
New York, NY 10016
Mailing address
50 Park Avenue
New York, NY 10016
Phone (212) 683-3181
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 |
|---|---|---|---|
| 046279 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285804800000",
"number": "1457660938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 PARK AVENUE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10016",
"telephone_number": "212-683-3181",
"fax_number": "212-684-4226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 PARK AVENUE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10016",
"telephone_number": "212-683-3181",
"fax_number": "212-684-4226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERMACK",
"first_name": "DEBRA",
"middle_name": "JILL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-30",
"last_updated": "2010-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "046279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
- Johanna Derisca
- David Derisse, DMD
- Joie Adam Deritis, LCSW
- Irina Derkacheva, MPS, LCAT
- Dermacare Medical P.C.
- Sihar Derman Aquino, MPA
- Dermatologic Surgery of Lexington Ave PC
- Dermatology Circle PLLC
- Dermatology Clinicians Group - Columbia University
- Dermatology Laser and Surgery of Carnegie Hill PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.