Individual provider Active NPI

Jolanta Drzymalski, DDS

  • Dentist
  • Albany, NY
National Provider Identifier
1730170291
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
050442 Issued in NY
Practice address
920 Lark Dr
Albany, NY 12207-1300
Phone
(518) 465-4771
Fax
(518) 242-4784
NPI assigned
Nov 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 050442 NY Primary

Addresses

Primary practice location

920 Lark Dr
Albany, NY 12207-1300

Mailing address

920 Lark Dr
Albany, NY 12207-1300
Phone (518) 465-4771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210304001464 NY Practitioner - Dentist 5890094601 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
050442NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc. CurrentSince Mar 8, 2021 Accepting new patients
Sun River Health Inc Current Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

1 Paradies Ln
New Paltz, NY 12561
Phone (845) 255-1760

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1730170291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 LARK DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122071300",
            "telephone_number": "518-465-4771",
            "fax_number": "518-242-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 LARK DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122071300",
            "telephone_number": "518-465-4771",
            "fax_number": "518-242-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRZYMALSKI",
        "first_name": "JOLANTA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "050442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.