Genaro J Taveras I, 048917

Primary specialty

DentistTaxonomy code 122300000X

License

048917 Issued in NY

Practice address

2002 Grand Ave
Bronx, NY 10453-4662

Phone

(718) 299-1340

Fax

(718) 299-2760

NPI assigned

Sep 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Genaro Taveras Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bonita Sonrisa Dental Mso

  • Public Health Dentistry
  • Bronx, NY
  • NPI 1790325884
  NPD (past)
• Spore Test Inc

  • Dentist
  • Bronx, NY
  • NPI 1902533342
  NPD (past)

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1932396645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 GRAND AV.",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534662",
            "telephone_number": "718-299-1340",
            "fax_number": "718-299-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 GRAND AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534662",
            "telephone_number": "718-299-1340",
            "fax_number": "718-299-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERAS",
        "first_name": "GENARO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "048917",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "048917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02152812",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENARO",
            "last_name": "TAVERAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aimee Taveras
• Anyelis Taveras
• Cleidys Taveras, MS
• Elizabeth Taveras, MS ED
• Gabriela Taveras, NP
• Jose Martin Taveras, M.D.
• Luisa Taveras
• Maria Taveras
• Norberto R. Taveras, LMSW
• Patxis Esteban Taveras, MD

• Dentist in Bronx, NY
• Providers in Bronx, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.