Individual provider Active NPI

Joseph Paul Gulbenkian, DDS

  • Dentist
  • New York, NY
National Provider Identifier
1962523316
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
047470 Issued in NY
Practice address
162 W 56TH St
New York, NY 10019-3831
Phone
(212) 977-6765
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 047470 NY Primary

Addresses

Primary practice location

162 W 56TH St
New York, NY 10019-3831

Mailing address

333 E 75TH St
9K
New York, NY 10021-3049
Phone (212) 737-7043

Other identifiers 1

IdentifierTypeStateIssuer
02108230MedicaidNY

Other names 1

  • Dr. Joseph Paul Gulbenkian Professional name

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
I20150625000415 NY Order and Referring Only - DentistPractitioner - Dentist 8224349725

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047470NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962523316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E 75TH ST",
            "address_2": "9K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213049",
            "telephone_number": "212-737-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 W 56TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193831",
            "telephone_number": "212-977-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULBENKIAN",
        "first_name": "JOSEPH",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "047470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02108230",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSEPH",
            "last_name": "GULBENKIAN",
            "middle_name": "PAUL",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.