Andzelika Gumieniak, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

41136 Issued in TX

Practice address

6515 Westworth Blvd
Westworth Village, TX 76114-4058

Phone

(917) 485-1066

NPI assigned

Jun 26, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1558047241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 STRONG ST",
            "city": "WALLINGTON",
            "state": "NJ",
            "postal_code": "070571417",
            "telephone_number": "917-485-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6515 WESTWORTH BLVD",
            "city": "WESTWORTH VILLAGE",
            "state": "TX",
            "postal_code": "761144058",
            "telephone_number": "917-485-1066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Avenue C",
            "address_purpose": "LOCATION",
            "city": "Bayonne",
            "state": "NJ",
            "postal_code": "070025109",
            "country_code": "US",
            "telephone_number": "917-485-1066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUMIENIAK",
        "first_name": "ANDZELIKA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI3052100",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "41136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Westworth Village, TX
• Providers in Westworth Village, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.