Consuelo Trinidad Poveda, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

045030-1 Issued in NY

Practice address

3721 75TH St
Jackson Heights, NY 11372-6405

Phone

(718) 476-3800

Fax

(718) 533-7808

NPI assigned

Sep 20, 2006

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

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.

• Centro Dental Familiar P.C

  • Dentist
  • Jackson HTS, NY
  • NPI 1124018700
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1942308366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3742 90TH ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727830",
            "telephone_number": "718-424-5559",
            "fax_number": "718-426-2428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 75TH ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726405",
            "telephone_number": "718-476-3800",
            "fax_number": "718-533-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POVEDA",
        "first_name": "CONSUELO",
        "middle_name": "TRINIDAD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "045030-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Karen Ponce, LCSW
• Elizama Pons-Montalvo
• Melissa Noemi Portan, LMSW, MED
• Humberto S. Portillo, M.D.
• Shannon Potts
• Prachi Corporation
• Jorge F Pradines, D.D.S
• Olga Alejandra Preciado, LMSW
• Primary Zone Chiropractic. PC
• Prime Health Medical Supplies

• Dentist in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.