Individual provider Active NPI

Mariolys Tamayo

  • General Practice Dentistry
  • Bronx, NY
National Provider Identifier
1699268045
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
060596 Issued in NY
Practice address
6299 Broadway Apt C11
Bronx, NY 10471-3177
Phone
(347) 606-0228
NPI assigned
Jun 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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
General Practice Dentistry 1223G0001X 060596 NY Primary

Addresses

Primary practice location

6299 Broadway Apt C11
Bronx, NY 10471-3177

Mailing address

6299 Broadway Apt C11
Bronx, NY 10471-3177
Phone (347) 606-0228

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
060596NYMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1699268045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6299 BROADWAY APT C11",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104713177",
            "telephone_number": "347-606-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6299 BROADWAY APT C11",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104713177",
            "telephone_number": "347-606-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMAYO",
        "first_name": "MARIOLYS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "060596",
            "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 Oct 11, 2019; 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.