Individual provider Active NPI

Carlos Alfonso, DDS,MS, DIPLOMATE

  • Prosthodontics
  • New York, NY
National Provider Identifier
1528111580
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
0450071 Issued in NY
Practice address
100 Post Ave # 102
New York, NY 10034-3406
Phone
(646) 796-2727
Fax
(646) 796-7777
NPI assigned
Jan 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 0450071 NY Primary

Addresses

Primary practice location

100 Post Ave # 102
New York, NY 10034-3406

Mailing address

100 Post Ave # 102
New York, NY 10034-3406
Phone (646) 796-2727

Other identifiers 1

IdentifierTypeStateIssuer
01680482MedicaidNY

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0450071NYMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1528111580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 POST AVE # 102",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343406",
            "telephone_number": "646-796-2727",
            "fax_number": "646-796-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 POST AVE # 102",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343406",
            "telephone_number": "646-796-2727",
            "fax_number": "646-796-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFONSO",
        "first_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "DDS,MS, DIPLOMATE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "0450071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01680482",
            "state": "NY"
        }
    ],
    "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 9, 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.