Individual provider Active NPI

Mariam Vonderheide Pincus

  • Prosthodontics
  • Brooklyn, NY
National Provider Identifier
1609379205
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
062059 Issued in NY
Practice address
44 Court St Ste 808
Brooklyn, NY 11201-4414
Phone
(718) 857-6639
NPI assigned
Mar 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 062059 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

44 Court St Ste 808
Brooklyn, NY 11201-4414

Mailing address

147 Montague St Apt 1
Brooklyn, NY 11201-3539
Phone (585) 610-9135

Other practice location 1

130 E 18th St Ofc 1M
New York, NY 10003-2400
Phone (212) 254-5454

Other practice location 2

160 Broadway Rm 1203
New York, NY 10038-4211
Phone (212) 227-7390

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
062059NYMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
44 Court Street Dentists PLLC Prosthodontics CurrentSince Oct 20, 2024 Accepting new patients

Locations

44 Court St
Ste 808
Brooklyn, NY 11201
Phone (718) 857-6639

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1520640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1609379205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 MONTAGUE ST APT 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013539",
            "telephone_number": "585-610-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 COURT ST STE 808",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014414",
            "telephone_number": "718-857-6639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 E 18th St Ofc 1M",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100032400",
            "country_code": "US",
            "telephone_number": "212-254-5454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 Broadway Rm 1203",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100384211",
            "country_code": "US",
            "telephone_number": "212-227-7390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINCUS",
        "first_name": "MARIAM",
        "middle_name": "VONDERHEIDE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-10",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "062059",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Dec 4, 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.