Individual provider Active NPI

Rebecca Ann Dunninger, DDS

  • Pediatric Dentistry
  • Smithtown, NY
National Provider Identifier
1720610686
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
063457-01 Issued in NY
Practice address
1030 W Jericho Tpke
Smithtown, NY 11787-3215
Phone
(631) 486-6364
NPI assigned
Feb 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 063457-01 NY Primary

Addresses

Primary practice location

1030 W Jericho Tpke
Smithtown, NY 11787-3215

Mailing address

18 Paprocki Ave
West Islip, NY 11795-2915

Other practice location 1

3237 Route 112 Ste 6
Medford, NY 11763-1424
Phone (631) 320-0880

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
063457-01NYMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1581206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1720610686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 PAPROCKI AVE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 W JERICHO TPKE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873215",
            "telephone_number": "631-486-6364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3237 Route 112 Ste 6",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "NY",
            "postal_code": "117631424",
            "country_code": "US",
            "telephone_number": "631-320-0880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNNINGER",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-09",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "063457-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.

Verify at the official NPI Registry.