Individual provider Active NPI

Teodora R. Constantinescu, DDS

  • Dentist
  • Middle Village, NY
National Provider Identifier
1770973836
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
033300 Issued in NY
Practice address
7812 Metropolitan Ave
Middle Village, NY 11379-2965
Phone
(718) 821-5573
NPI assigned
Jan 28, 2015
Last updated
Jan 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 033300 NY Primary

Addresses

Primary practice location

7812 Metropolitan Ave
Middle Village, NY 11379-2965

Mailing address

7812 Metropolitan Ave
Middle Village, NY 11379-2965
Phone (718) 821-5573

Other identifiers 1

IdentifierTypeStateIssuer
033300OtherNYDENTAL LINCENSE NUMBER

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
I20150408002176 NY Order and Referring Only - DentistPractitioner - Dentist 2860710548

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033300NYMDDental Hygienist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1770973836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7812 METROPOLITAN AVE",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792965",
            "telephone_number": "718-821-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7812 METROPOLITAN AVE",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792965",
            "telephone_number": "718-821-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANTINESCU",
        "first_name": "TEODORA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-28",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "033300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LINCENSE NUMBER",
            "identifier": "033300",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Village, NY

Sources for this page

Verify at the official NPI Registry.