Active NPI
Luiz Andre Pimenta, DDS, MS, MBA, PHD
- Prosthodontics
- New York, NY
National Provider Identifier
1912089582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 000130
- Practice address
- 630 W 168TH St
New York, NY 10032-3725 - Phone
- (212) 305-6100
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 000130 | NY | Primary |
Addresses
Primary practice location
630 W 168TH St
New York, NY 10032-3725
Mailing address
630 West 168TH Street, P&S Box 20
New York, NY 10032
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
- Credentials
- Master of Business Administration, Master of Science, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000130 | NY | MD | Psychoanalyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665446400000",
"number": "1912089582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 WEST 168TH STREET, P&S BOX 20",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 W 168TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323725",
"telephone_number": "212-305-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIMENTA",
"first_name": "LUIZ",
"middle_name": "ANDRE",
"name_prefix": "Dr.",
"credential": "DDS, MS, MBA, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2022-10-11",
"certification_date": "2022-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NY",
"license": "000130",
"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 Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.