Individual provider Active NPI

Leslie B Goldfarb, D.D.S.

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1962518209
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
042081 Issued in NY
Practice address
501 5TH Ave
Suite 501
New York, NY 10017-6107
Phone
(212) 725-2950
Fax
(212) 447-0962
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 042081 NY Primary

Addresses

Primary practice location

501 5TH Ave
Suite 501
New York, NY 10017-6107

Mailing address

501 5TH Ave
RM 501
New York, NY 10017-7802
Phone (212) 725-2950

Other identifiers 1

IdentifierTypeStateIssuer
084880329OtherADA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160621000877 NY Order and Referring Only - DentistPractitioner - Dentist 6800187998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042081NYMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1962518209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 5TH AVE",
            "address_2": "RM 501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100177802",
            "telephone_number": "212-725-2950",
            "fax_number": "212-447-0962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 5TH AVE",
            "address_2": "SUITE 501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176107",
            "telephone_number": "212-725-2950",
            "fax_number": "212-447-0962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDFARB",
        "first_name": "LESLIE",
        "middle_name": "B",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "042081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADA",
            "identifier": "084880329",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.