Active NPI
Jessica N Madrid
- Dentist
- Garden City, NY
National Provider Identifier
1669826707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 059483-1
- Practice address
- 520 Franklin Ave Ste 204
Garden City, NY 11530-5815 - Phone
- (516) 754-0430
- NPI assigned
- Apr 14, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NY | ||
| Dentist | 122300000X | 059483-1 | NY | Primary |
Addresses
Primary practice location
520 Franklin Ave Ste 204
Garden City, NY 11530-5815
Mailing address
520 Franklin Ave Ste 204
Garden City, NY 11530-5815
Phone (516) 417-8820
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
| License | State | Type | Specialty |
|---|---|---|---|
| 059483-1 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735171200000",
"number": "1669826707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 FRANKLIN AVE STE 204",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115305815",
"telephone_number": "516-417-8820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 FRANKLIN AVE STE 204",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115305815",
"telephone_number": "516-754-0430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADRID",
"first_name": "JESSICA",
"middle_name": "N",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-14",
"last_updated": "2024-12-26",
"certification_date": "2024-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "059483-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.