Active NPI
Manju Gopinathan, DDS, MS
- Endodontics
- Bronx, NY
National Provider Identifier
1689714990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 052430-1
- Practice address
- 1530 Unionport Rd
Bronx, NY 10462-7801 - Phone
- (212) 980-1408
- Fax
- (212) 685-4507
- NPI assigned
- Feb 7, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 052430-1 | NY | Primary |
Addresses
Primary practice location
1530 Unionport Rd
Bronx, NY 10462-7801
Mailing address
630 1St Ave
Apt # 16 M
New York, NY 10016-3700
Phone (212) 689-7873
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 052430-1 | NY | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301616000000",
"number": "1689714990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 1ST AVE",
"address_2": "APT # 16 M",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100163700",
"telephone_number": "212-689-7873",
"fax_number": "212-685-4507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1530 UNIONPORT RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104627801",
"telephone_number": "212-980-1408",
"fax_number": "212-685-4507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOPINATHAN",
"first_name": "MANJU",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2011-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NY",
"license": "052430-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.