NPIMap

Individual provider Active NPI

Artem Krutyansky, DMD MD MPH

  • Oral and Maxillofacial Surgery (Dentist)
  • New York, NY
National Provider Identifier
1710411525
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
064142-01 Issued in NY
Practice address
630 W 168TH St
New York, NY 10032-3725
Phone
(212) 305-4552
NPI assigned
Apr 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 40017 OK
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 236 OK
Surgery Physician 208600000X 332158 NY
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 064142-01 NY Primary

Addresses

Primary practice location

630 W 168TH St
New York, NY 10032-3725

Mailing address

630 W 168TH St RM 250
New York, NY 10032-3725
Phone (212) 305-4552

Other practice location 1

1 N Broadway Ste 111
White Plains, NY 10601-2322
Phone (914) 729-7910

Other practice location 2

51 W 51st St
New York, NY 10019-6113
Phone (212) 326-8520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240903001489 NY Practitioner - Oral SurgeryPractitioner - Dentist 2163961277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Rutgers New Jersey Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
064142-01NYMDOral and Maxillofacial Surgery (Dentist)
332158NYMDSurgery Physician
40017OKMDSurgery Physician
236OKMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Jul 31, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Oral & Maxillofacial Surgery Current Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jul 31, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Oral and Maxillofacial Surgery CurrentSince Jun 16, 2024 Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

Locations

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

630 W 168th St
Rm 250
New York, NY 10032
Phone (212) 305-7626

630 W 168th St
#7250
New York, NY 10032

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: bwy9004@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1710411525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST RM 250",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-305-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-305-4552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 N Broadway Ste 111",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106012322",
            "country_code": "US",
            "telephone_number": "914-729-7910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 W 51st St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100196113",
            "country_code": "US",
            "telephone_number": "212-326-8520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUTYANSKY",
        "first_name": "ARTEM",
        "name_prefix": "Dr.",
        "credential": "DMD MD MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "40017",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OK",
            "license": "236",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "332158",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "064142-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.