Active NPI
Dorota Kulicka-Sobocinski, DDS
- Prosthodontics
- Baldwin, NY
National Provider Identifier
1962642041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 047696
- Practice address
- 1000 Atlantic Ave
Baldwin, NY 11510-4247 - Phone
- (516) 771-7777
- Fax
- (516) 771-6080
- NPI assigned
- Mar 2, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 047696 | NY | Primary |
Addresses
Primary practice location
1000 Atlantic Ave
Baldwin, NY 11510-4247
Mailing address
25 Neptune Blvd Apt 2H
Long Beach, NY 11561-4643
Phone (516) 771-7777
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160125001266 | NY | Order and Referring Only - Dentist | 6305149436 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235952000000",
"number": "1962642041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 NEPTUNE BLVD APT 2H",
"city": "LONG BEACH",
"state": "NY",
"postal_code": "115614643",
"telephone_number": "516-771-7777",
"fax_number": "516-771-6080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 ATLANTIC AVE",
"city": "BALDWIN",
"state": "NY",
"postal_code": "115104247",
"telephone_number": "516-771-7777",
"fax_number": "516-771-6080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KULICKA-SOBOCINSKI",
"first_name": "DOROTA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-02",
"last_updated": "2009-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NY",
"license": "047696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baldwin, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.