Individual provider Active NPI

Elizabeth Ellen Block

  • Dentist
  • New York, NY
National Provider Identifier
1477880235
Registry record updated Nov 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
39469 Issued in NY
Practice address
817 Broadway
New York, NY 10003-4709
Phone
(212) 473-4700
NPI assigned
Nov 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 39469 NY Primary

Addresses

Primary practice location

817 Broadway
New York, NY 10003-4709

Mailing address

817 Broadway
New York, NY 10003-4709
Phone (212) 473-4700

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
39469NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1258156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258156800000",
    "number": "1477880235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034709",
            "telephone_number": "212-473-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034709",
            "telephone_number": "212-473-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "ELIZABETH",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-14",
        "last_updated": "2009-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "39469",
            "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 Nov 14, 2009; 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.