Individual provider Active NPI

Jeffrey Ben Rappaport, D.D.S.

  • Dentist
  • New York, NY
National Provider Identifier
1942519095
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
054586-1 Issued in NY
Practice address
474 6TH Ave
New York, NY 10011-8414
Phone
(212) 837-1833
NPI assigned
Oct 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 054586-1 NY Primary

Addresses

Primary practice location

474 6TH Ave
New York, NY 10011-8414

Mailing address

330 E 72ND St
New York, NY 10021-4700
Phone (413) 530-2228

Other practice location 1

890 Mountain Ave Ste 310
New Providence, NJ 07974-1218
Phone (212) 879-1845

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
054586-1NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
MJR Dental Services LLC Dentist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1942519095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E 72ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214700",
            "telephone_number": "413-530-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 6TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118414",
            "telephone_number": "212-837-1833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "890 Mountain Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "New Providence",
            "state": "NJ",
            "postal_code": "079741218",
            "country_code": "US",
            "telephone_number": "212-879-1845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAPPAPORT",
        "first_name": "JEFFREY",
        "middle_name": "BEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-06",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054586-1",
            "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 Jan 8, 2019; 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.