Individual provider Active NPI

Diana Vanessa Bernal-Munoz

  • Dental Hygienist
  • Long Island City, NY
National Provider Identifier
1508686437
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
007074 Issued in NY
Practice address
2101 41St Ave
Long Island City, NY 11101-4801
Phone
(718) 784-2240
Fax
(914) 471-8022
NPI assigned
Oct 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 007074 NY Primary

Addresses

Primary practice location

2101 41St Ave
Long Island City, NY 11101-4801

Mailing address

14639 14TH Ave Apt B3
Whitestone, NY 11357-2401
Phone (929) 316-1600

Other names 1

  • Diana Vanessa Bernal-Munoz Professional name

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
007074NYMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1508686437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14639 14TH AVE APT B3",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113572401",
            "telephone_number": "929-316-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 41ST AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014801",
            "telephone_number": "718-784-2240",
            "fax_number": "914-471-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNAL-MUNOZ",
        "first_name": "DIANA",
        "middle_name": "VANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NY",
            "license": "007074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "BERNAL-MUNOZ",
            "middle_name": "VANESSA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.