Active NPI
Ross Wengrover, D.D.S.
- Pediatric Dentistry
- New York, NY
National Provider Identifier
1467813808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 059874
- Practice address
- 1317 3Rd Ave FL 6
New York, NY 10021-2956 - Phone
- (212) 355-7760
- NPI assigned
- Mar 13, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Dentistry | 1223P0221X | 059874 | NY | Primary |
Addresses
Primary practice location
1317 3Rd Ave FL 6
New York, NY 10021-2956
Mailing address
301 E 38TH St Apt 5a
New York, NY 10016-2764
Phone (631) 484-6186
Other practice location 1
107 S Broadway
Yonkers, NY 10701-4006
Phone (914) 378-7848
Other practice location 2
345 E 24th St
New York, NY 10010-4020
Phone (212) 998-9800
Other practice location 3
345 E 24th St
New York, NY 10010-4020
Phone (212) 998-9800
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 |
|---|---|---|---|
| 059874 | NY | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532995200000",
"number": "1467813808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 E 38TH ST APT 5A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100162764",
"telephone_number": "631-484-6186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1317 3RD AVE FL 6",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100212956",
"telephone_number": "212-355-7760"
}
],
"practiceLocations": [
{
"address_1": "107 S Broadway",
"address_purpose": "LOCATION",
"city": "Yonkers",
"state": "NY",
"postal_code": "107014006",
"country_code": "US",
"telephone_number": "914-378-7848",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "345 E 24th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100104020",
"country_code": "US",
"telephone_number": "212-998-9800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "345 E 24th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100104020",
"country_code": "US",
"telephone_number": "212-998-9800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WENGROVER",
"first_name": "ROSS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-13",
"last_updated": "2018-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "059874",
"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 Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.