Individual provider Active NPI

Gwen M. Engelhard, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1467584045
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
37587 Issued in NY
Practice address
212 W 15TH St
First Floor
New York, NY 10011-6577
Phone
(212) 243-2023
Fax
(212) 243-2687
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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 37587 NY Primary

Addresses

Primary practice location

212 W 15TH St
First Floor
New York, NY 10011-6577

Mailing address

55 E End Ave
Apt. 14C
New York, NY 10028-7928
Phone (212) 243-2023

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
37587NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1467584045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E END AVE",
            "address_2": "APT. 14C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100287928",
            "telephone_number": "212-243-2023",
            "fax_number": "212-243-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W 15TH ST",
            "address_2": "FIRST FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116577",
            "telephone_number": "212-243-2023",
            "fax_number": "212-243-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELHARD",
        "first_name": "GWEN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "37587",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 20, 2019; 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.