Adriana Mediavilla, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

063481 Issued in NY

Practice address

1405 Old Northern Blvd
Roslyn, NY 11576-2252

Phone

(516) 801-6777

NPI assigned

May 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1871239152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 OLD NORTHERN BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115762252",
            "telephone_number": "516-801-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDIAVILLA",
        "first_name": "ADRIANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-09",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "063481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MBS Health Collective Inc.
• Joanne McDevitt, P.A.
• Bridget McGarry, P.A.
• Nora Ann McGee
• Kathleen Therese McLaughlin, RPA-C, ATC
• Bhoomi Mehrotra, MD
• Robert Mendelsohn, PH.D.
• Robin Mendelsohn, PH.D
• Jennifer Marie Mendocha, D.D.S.
• Celia Merritt, LCSW

• General Practice Dentistry in Roslyn, NY
• Providers in Roslyn, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.