Active NPI
Yelena Gutman, DDS
- Dentist
- Brooklyn, NY
National Provider Identifier
1598859332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 045541
- Practice address
- 2102 E 24TH St
Brooklyn, NY 11229-4902 - Phone
- (718) 368-0900
- Fax
- (718) 368-0107
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 045541 | NY | Primary |
Addresses
Primary practice location
2102 E 24TH St
Brooklyn, NY 11229-4902
Mailing address
247 Garden St
Oceanside, NY 11572-4317
Phone (718) 368-0900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01651147 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 5, 2016 through Jan 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045541 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598859332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "247 GARDEN ST",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115724317",
"telephone_number": "718-368-0900",
"fax_number": "718-368-0107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2102 E 24TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112294902",
"telephone_number": "718-368-0900",
"fax_number": "718-368-0107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTMAN",
"first_name": "YELENA",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "045541",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01651147",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.