Individual provider Active NPI

Mark Zharnitsky Sr.

  • Dentist
  • Elmhurst, NY
National Provider Identifier
1538295530
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
041032 Issued in NY
Practice address
4010 82ND St
Elmhurst, NY 11373-1305
Phone
(718) 426-3333
Fax
(718) 426-6387
NPI assigned
Feb 26, 2007
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
Dentist 122300000X 041032 NY Primary

Addresses

Primary practice location

4010 82ND St
Elmhurst, NY 11373-1305

Mailing address

4010 82ND St
Elmhurst, NY 11373-1305
Phone (718) 426-3333

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
I20151229001407 NY Order and Referring Only - DentistPractitioner - Dentist 6507167079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041032NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538295530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 82ND ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731305",
            "telephone_number": "718-426-3333",
            "fax_number": "718-426-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 82ND ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731305",
            "telephone_number": "718-426-3333",
            "fax_number": "718-426-6387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHARNITSKY",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "041032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.