Individual provider Active NPI

Trina Marie Bunag Villanueva, DDS

  • Dentist
  • New York, NY
National Provider Identifier
1649896473
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02905900 Issued in NJ
Practice address
345 E 24TH St
New York, NY 10010-4020
Phone
(212) 998-9800
NPI assigned
Jun 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 22DI02905900 NJ Primary

Addresses

Primary practice location

345 E 24TH St
New York, NY 10010-4020

Mailing address

124 E 24TH St Apt 1B
New York, NY 10010-3612
Phone (718) 619-1667

Other practice location 1

65 Jefferson Ave
Elizabeth, NJ 07201-2474
Phone (908) 469-9100

Other practice location 2

NYU Langone Medical Center
550 First Avenue
New York, NY 10016
Phone (212) 263-5506

Other practice location 3

66 Somme St
Newark, NJ 07105-3612
Phone (973) 578-8788

Other practice location 4

509 Orange St
Newark, NJ 07107-2128
Phone (973) 481-5000

Other practice location 5

462 1st Ave
New York, NY 10016-9196
Phone (212) 562-5300

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
22DI02905900NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Michael J. Diamond, PA Past Accepting new patients
Orange St Dental Associates LLC Dentist Past Accepting new patients

Organizations & group practices 2

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": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1649896473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E 24TH ST APT 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100103612",
            "telephone_number": "718-619-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 E 24TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104020",
            "telephone_number": "212-998-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Elizabeth",
            "state": "NJ",
            "postal_code": "072012474",
            "country_code": "US",
            "telephone_number": "908-469-9100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "NYU Langone Medical Center",
            "address_2": "550 First Avenue",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10016",
            "country_code": "US",
            "telephone_number": "212-263-5506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "66 Somme St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071053612",
            "country_code": "US",
            "telephone_number": "973-578-8788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "509 Orange St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071072128",
            "country_code": "US",
            "telephone_number": "973-481-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "462 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100169196",
            "country_code": "US",
            "telephone_number": "212-562-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "TRINA MARIE",
        "middle_name": "BUNAG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02905900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.