Individual provider Active NPI

Ingrid Ruth Prieditis, D.D.S.

  • General Practice Dentistry
  • White Plains, NY
National Provider Identifier
1811139579
Registry record updated Mar 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
038586-1 Issued in NY
Practice address
280 Mamaroneck Ave Ste 107
Suite 107
White Plains, NY 10605-1459
Phone
(914) 946-3526
NPI assigned
Mar 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2009

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 038586-1 NY Primary

Addresses

Primary practice location

280 Mamaroneck Ave Ste 107
Suite 107
White Plains, NY 10605-1459

Mailing address

280 Mamaroneck Ave. Suite 107
Suite 107
White Plains, NY 10605
Phone (914) 946-3526

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
038586-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238112000000",
    "number": "1811139579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 MAMARONECK AVE. SUITE 107",
            "address_2": "SUITE 107",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "10605",
            "telephone_number": "914-946-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 MAMARONECK AVE STE 107",
            "address_2": "SUITE 107",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051459",
            "telephone_number": "914-946-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIEDITIS",
        "first_name": "INGRID",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-27",
        "last_updated": "2009-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "038586-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2009; 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.