Individual provider Active NPI

Patricia I Pena Arce, DDS

  • General Practice Dentistry
  • Brentwood, NY
National Provider Identifier
1740201169
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
042852 Issued in NY
Practice address
55 2ND Ave Unit 8
Brentwood, NY 11717-4665
Phone
(631) 231-7960
Fax
(631) 231-7987
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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 042852 NY Primary

Addresses

Primary practice location

55 2ND Ave Unit 8
Brentwood, NY 11717-4665

Mailing address

55 2ND Ave Unit 8
Brentwood, NY 11717-4665
Phone (631) 231-7960

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
042852NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1740201169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 2ND AVE UNIT 8",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174665",
            "telephone_number": "631-231-7960",
            "fax_number": "631-231-7987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 2ND AVE UNIT 8",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174665",
            "telephone_number": "631-231-7960",
            "fax_number": "631-231-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA ARCE",
        "first_name": "PATRICIA",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "042852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; 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.