Individual provider Active NPI

Gerald S Wank, DDS

  • Dentist
  • Great Neck, NY
National Provider Identifier
1639266505
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18628 Issued in NY
Practice address
40 Bayview Ave
Great Neck, NY 11021
Phone
(516) 487-7877
Fax
(516) 487-7880
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18628 NY Primary
Dentist 122300000X 22D100S52800 NJ
Dentist 122300000X 002633 CT

Addresses

Primary practice location

40 Bayview Ave
Great Neck, NY 11021

Mailing address

40 Bayview Ave
Great Neck, NY 11021
Phone (516) 487-7877

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
002633CTMDDentist
22D100S52800NJMDDentist
18628NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639266505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BAYVIEW AVE",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11021",
            "telephone_number": "516-487-7877",
            "fax_number": "516-487-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BAYVIEW AVE",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11021",
            "telephone_number": "516-487-7877",
            "fax_number": "516-487-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANK",
        "first_name": "GERALD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "18628",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D100S52800",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "002633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.