Individual provider Active NPI

Yakov Podlipsky, D.D.S

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1477543437
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
043560 Issued in NY
Practice address
2084 E 17TH St
Floor 2
Brooklyn, NY 11229-3802
Phone
(718) 336-9202
Fax
(718) 376-7280
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 043560 NY Primary

Addresses

Primary practice location

2084 E 17TH St
Floor 2
Brooklyn, NY 11229-3802

Mailing address

2084 E 17TH St
Floor 2
Brooklyn, NY 11229-3802
Phone (718) 336-9202

Other identifiers 1

IdentifierTypeStateIssuer
01269790MedicaidNY

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
043560NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477543437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2084 E 17TH ST",
            "address_2": "FLOOR 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293802",
            "telephone_number": "718-336-9202",
            "fax_number": "718-376-7280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2084 E 17TH ST",
            "address_2": "FLOOR 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293802",
            "telephone_number": "718-336-9202",
            "fax_number": "718-376-7280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODLIPSKY",
        "first_name": "YAKOV",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "043560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01269790",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.