Individual provider Active NPI

Vitaly V Vaynshteyn, DDS

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1861691404
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0399031 Issued in NY
Practice address
424 Brighton Beach Ave
Brooklyn, NY 11235
Phone
(718) 646-5013
NPI assigned
Jul 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0399031 NY Primary

Addresses

Primary practice location

424 Brighton Beach Ave
Brooklyn, NY 11235

Mailing address

424 Brighton Beach Ave
Brooklyn, NY 11235
Phone (718) 646-5013

Other identifiers 1

IdentifierTypeStateIssuer
00944716MedicaidNY

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
0399031NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1861691404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 BRIGHTON BEACH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11235",
            "telephone_number": "718-646-5013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 BRIGHTON BEACH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11235",
            "telephone_number": "718-646-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAYNSHTEYN",
        "first_name": "VITALY",
        "middle_name": "V",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0399031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00944716",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.