Individual provider Active NPI

Vincent Ayuko

  • Dentist
  • Brewster, NY
National Provider Identifier
1477520104
Registry record updated Jun 28, 2013
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
051384 Issued in NY
Practice address
1620 Route 22
Brewster, NY 10509-4051
Phone
(845) 279-4999
Fax
(845) 279-7915
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 051384 NY Primary

Addresses

Primary practice location

1620 Route 22
Brewster, NY 10509-4051

Mailing address

1620 Route 22
Brewster, NY 10509-4051
Phone (845) 279-4999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150821013068 NY Order and Referring Only - DentistPractitioner - Dentist 4284949173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
051384NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1477520104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 ROUTE 22",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094051",
            "telephone_number": "845-279-4999",
            "fax_number": "845-279-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 ROUTE 22",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094051",
            "telephone_number": "845-279-4999",
            "fax_number": "845-279-7915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYUKO",
        "first_name": "VINCENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "051384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

Verify at the official NPI Registry.