Individual provider Active NPI

Rafael M Muniz, DDS

  • General Practice Dentistry
  • Jackson Heights, NY
National Provider Identifier
1730204991
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
048338 Issued in NY
Practice address
3550 82ND St Ste 1C
Jackson Heights, NY 11372-5130
Phone
(718) 639-7720
Fax
(718) 639-7969
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 048338 NY Primary

Addresses

Primary practice location

3550 82ND St Ste 1C
Jackson Heights, NY 11372-5130

Mailing address

3550 82ND St Ste 1C
Jackson Heights, NY 11372-5130
Phone (718) 639-7720

Other identifiers 1

IdentifierTypeStateIssuer
02050246MedicaidNY

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
048338NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730204991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 82ND ST STE 1C",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113725130",
            "telephone_number": "718-639-7720",
            "fax_number": "718-639-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 82ND ST STE 1C",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113725130",
            "telephone_number": "718-639-7720",
            "fax_number": "718-639-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNIZ",
        "first_name": "RAFAEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02050246",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.