Individual provider Active NPI

Luz Amparo Krestin, D.D.S.

  • General Practice Dentistry
  • White Plains, NY
National Provider Identifier
1669717096
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
043280 Issued in NY
Practice address
10 Mitchell PL
Ste.102
White Plains, NY 10601-4342
Phone
(914) 683-5203
Fax
(914) 289-0846
NPI assigned
Dec 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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 043280 NY Primary

Addresses

Primary practice location

10 Mitchell PL
Ste.102
White Plains, NY 10601-4342

Mailing address

10 Mitchell PL
Ste.102
White Plains, NY 10601-4342
Phone (914) 683-5203

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
043280NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
White Plains Dental Provider PLLC Past Accepting new patients
Dental and Cosmetic Group of Westchester 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": "1355270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1669717096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MITCHELL PL",
            "address_2": "STE.102",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014342",
            "telephone_number": "914-683-5203",
            "fax_number": "914-289-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MITCHELL PL",
            "address_2": "STE.102",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014342",
            "telephone_number": "914-683-5203",
            "fax_number": "914-289-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRESTIN",
        "first_name": "LUZ",
        "middle_name": "AMPARO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-12",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "043280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.