Individual provider Active NPI

Conor Elizabeth Gruffi, DDS

  • General Practice Dentistry
  • Spring Valley, NY
National Provider Identifier
1558865766
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
060939 Issued in NY
Practice address
2 Perlman Dr Ste 101
Spring Valley, NY 10977-5230
Phone
(518) 641-2127
NPI assigned
Mar 21, 2018
Last updated
Jan 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 060939 NY Primary

Addresses

Primary practice location

2 Perlman Dr Ste 101
Spring Valley, NY 10977-5230

Mailing address

2 Perlman Dr Ste 101
Spring Valley, NY 10977-5230
Phone (845) 573-9860

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
I20190110001137 NY Order and Referring Only - DentistPractitioner - Dentist 8820334915

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
060939NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1558865766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PERLMAN DR STE 101",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775230",
            "telephone_number": "845-573-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PERLMAN DR STE 101",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775230",
            "telephone_number": "518-641-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUFFI",
        "first_name": "CONOR",
        "middle_name": "ELIZABETH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "060939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, NY

Sources for this page

Verify at the official NPI Registry.