Individual provider Active NPI

Katie Passman, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • New York, NY
National Provider Identifier
1942707773
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
058175 Issued in NY
Practice address
29 Cooper St
New York, NY 10034-3818
Phone
(212) 567-3368
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 058175 NY Primary

Addresses

Primary practice location

29 Cooper St
New York, NY 10034-3818

Mailing address

6 W 77TH St Apt 7B
New York, NY 10024-5125
Phone (917) 921-7584

Other names 1

  • Katie Yoo Former name

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 Science

State licenses

LicenseStateTypeSpecialty
058175NYMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1942707773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 W 77TH ST APT 7B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245125",
            "telephone_number": "917-921-7584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 COOPER ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343818",
            "telephone_number": "212-567-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSMAN",
        "first_name": "KATIE",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "058175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "YOO",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Apr 9, 2018; 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.