Individual provider Active NPI

Cheryl B Worrell, D.M.D.

  • General Practice Dentistry
  • Staten Island, NY
National Provider Identifier
1598734949
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
040844 Issued in NY
Practice address
35 Willowbrook Rd
Staten Island, NY 10302-2221
Phone
(718) 448-0266
Fax
(718) 448-3491
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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 040844 NY Primary

Addresses

Primary practice location

35 Willowbrook Rd
Staten Island, NY 10302-2221

Mailing address

35 Willowbrook Rd
Staten Island, NY 10302-2221
Phone (718) 448-0266

Other identifiers 1

IdentifierTypeStateIssuer
01066908MedicaidNY

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1598734949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 WILLOWBROOK RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022221",
            "telephone_number": "718-448-0266",
            "fax_number": "718-448-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 WILLOWBROOK RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022221",
            "telephone_number": "718-448-0266",
            "fax_number": "718-448-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORRELL",
        "first_name": "CHERYL",
        "middle_name": "B",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01066908",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.