Individual provider Active NPI

Jennifer Jane Burrell, D.D.S.

  • Prosthodontics
  • New York, NY
National Provider Identifier
1861605503
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
041025 Issued in NY
Practice address
515 Madison Ave
Suite 1212
New York, NY 10022-5403
Phone
(212) 317-0277
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 041025 NY Primary

Addresses

Primary practice location

515 Madison Ave
Suite 1212
New York, NY 10022-5403

Mailing address

435 E 57TH St Apt 14B
New York, NY 10022-3062
Phone (212) 317-0277

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
041025NYMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1861605503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 E 57TH ST APT 14B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223062",
            "telephone_number": "212-317-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MADISON AVE",
            "address_2": "SUITE 1212",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225403",
            "telephone_number": "212-317-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRELL",
        "first_name": "JENNIFER",
        "middle_name": "JANE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "041025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.