Individual provider Active NPI

Robert Wade Zinderman, D.D.S.

  • General Practice Dentistry
  • Kingston, NY
National Provider Identifier
1639275043
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D28203 Issued in NY
Practice address
273 Hurley Ave
Kingston, NY 12401-2421
Phone
(845) 339-4100
Fax
(845) 339-1195
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D28203 NY Primary

Addresses

Primary practice location

273 Hurley Ave
Kingston, NY 12401-2421

Mailing address

117 Elisa Landi Dr
Kingston, NY 12401-7408
Phone (845) 339-4974

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
D28203NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639275043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELISA LANDI DR",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124017408",
            "telephone_number": "845-339-4974",
            "fax_number": "845-339-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 HURLEY AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012421",
            "telephone_number": "845-339-4100",
            "fax_number": "845-339-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZINDERMAN",
        "first_name": "ROBERT",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "D28203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, 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.