Active NPI
Mariam Vonderheide Pincus
- Prosthodontics
- Brooklyn, NY
National Provider Identifier
1609379205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 062059
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 062059 | NY | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 44 Court Street Dentists PLLC | Prosthodontics | Current | 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.
-
- Prosthodontics
- Brooklyn, NY
- NPI 1184445678
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.