Individual provider Active NPI

Kim Rooprai

  • General Practice Dentistry
  • Syracuse, NY
National Provider Identifier
1962073841
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.034636 Issued in IL
Practice address
301 Prospect Ave
Syracuse, NY 13203-1807
Phone
(315) 448-5111
NPI assigned
Jul 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.034636 IL Primary
Dentist 122300000X 062645 NY

Addresses

Primary practice location

301 Prospect Ave
Syracuse, NY 13203-1807

Mailing address

109 S Warren St Apt 809
Syracuse, NY 13202-5008
Phone (416) 873-5088

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
019.034636ILMDGeneral Practice Dentistry
062645NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1962073841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S WARREN ST APT 809",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132025008",
            "telephone_number": "416-873-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOPRAI",
        "first_name": "KIM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.034636",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062645",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; 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.