Active NPI
Julissa Demorizi, D.D.S
- Orthodontics and Dentofacial Orthopedics Dentistry
- New York, NY
National Provider Identifier
1467617449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 052026-1
- Practice address
- 2109 Broadway
Suite 201
New York, NY 10023-2138 - Phone
- (212) 874-0030
- NPI assigned
- Jul 19, 2008
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 052026-1 | NY | Primary |
Addresses
Primary practice location
2109 Broadway
Suite 201
New York, NY 10023-2138
Mailing address
201 E 86TH St
Apt. 25B
New York, NY 10028-3023
Phone (646) 382-6046
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 |
|---|---|---|---|
| 052026-1 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297036800000",
"number": "1467617449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 E 86TH ST",
"address_2": "APT. 25B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100283023",
"telephone_number": "646-382-6046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2109 BROADWAY",
"address_2": "SUITE 201",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100232138",
"telephone_number": "212-874-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMORIZI",
"first_name": "JULISSA",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-19",
"last_updated": "2011-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "052026-1",
"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 Feb 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.