Individual provider Active NPI

Roman Aronov, DDS

  • General Practice Dentistry
  • Flushing, NY
National Provider Identifier
1659935773
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
061266 Issued in NY
Practice address
13614 Northern Blvd Ste a
Flushing, NY 11354-6511
Phone
(718) 445-7030
NPI assigned
Apr 24, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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 061266 NY Primary

Addresses

Primary practice location

13614 Northern Blvd Ste a
Flushing, NY 11354-6511

Mailing address

11714 85TH Ave Apt B1
Richmond Hill, NY 11418-1816
Phone (917) 513-6431

Other practice location 1

1485 1st Ave
New York, NY 10075-1363
Phone (212) 535-4199

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
061266NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
888 Dental P.C. CurrentSince Dec 26, 2021 Accepting new patients
Flushing Family Dental Care, P.C. General Practice PastSince Dec 21, 2021 Accepting new patients
Dental Implant Solutions of New York General Practice PastSince Nov 1, 2020 Accepting new patients
Island Dental Associates PastSince Nov 1, 2020 Accepting new patients

Locations

13614 Northern Blvd
Ste A
Flushing, NY 11354
Phone (718) 445-7030

Organizations & group practices 4

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": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1659935773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11714 85TH AVE APT B1",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114181816",
            "telephone_number": "917-513-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13614 NORTHERN BLVD STE A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546511",
            "telephone_number": "718-445-7030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1485 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100751363",
            "country_code": "US",
            "telephone_number": "212-535-4199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARONOV",
        "first_name": "ROMAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-24",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.