Individual provider Active NPI

Marianna Farber, D.D.S.

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1972628915
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
046663 Issued in NY
Practice address
115 E 57TH St
Suite 1520
New York, NY 10022-2049
Phone
(212) 588-1500
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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 046663 NY Primary

Addresses

Primary practice location

115 E 57TH St
Suite 1520
New York, NY 10022-2049

Mailing address

120 Riverside Blvd
New York, NY 10069-0501
Phone (917) 797-2011

Other identifiers 1

IdentifierTypeStateIssuer
134114702MedicaidNY

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
I20160316000977 NY Order and Referring Only - DentistPractitioner - Dentist 9032415120

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1972628915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 RIVERSIDE BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100690501",
            "telephone_number": "917-797-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E 57TH ST",
            "address_2": "SUITE 1520",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222049",
            "telephone_number": "212-588-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARBER",
        "first_name": "MARIANNA",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134114702",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.