Individual provider Active NPI

Renna Nakhamis, D.D.S.

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1619941283
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
049657-1 Issued in NY
Practice address
544 92ND St
Brooklyn, NY 11209-6414
Phone
(718) 680-0005
Fax
(718) 680-0010
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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 049657-1 NY Primary

Addresses

Primary practice location

544 92ND St
Brooklyn, NY 11209-6414

Mailing address

544 92ND St
Brooklyn, NY 11209-6414
Phone (718) 680-0005

Other identifiers 1

IdentifierTypeStateIssuer
02207638MedicaidNY

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
I20150618002809 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1658682570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049657-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1619941283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 92ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112096414",
            "telephone_number": "718-680-0005",
            "fax_number": "718-680-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 92ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112096414",
            "telephone_number": "718-680-0005",
            "fax_number": "718-680-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKHAMIS",
        "first_name": "RENNA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049657-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02207638",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.