Pavel Niderman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

044976 Issued in NY

Practice address

2060 Lexington Ave FRNT 2
New York, NY 10035-1759

Phone

(212) 996-5996

Fax

(212) 996-0030

NPI assigned

Oct 19, 2005

Last updated

Jul 20, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pavel Niderman D.D.S Atlantic Dental

  • Dentist
  • New York, NY
  • NPI 1437372380

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1992794267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 LEXINGTON AVE FRNT 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351759",
            "telephone_number": "212-996-5996",
            "fax_number": "212-996-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 LEXINGTON AVE FRNT 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351759",
            "telephone_number": "212-996-5996",
            "fax_number": "212-996-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIDERMAN",
        "first_name": "PAVEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "044976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Nicotra, CRNA
• Normina Nicotra, CRNA
• Nicseb Medical PC
• Jacob Niculcea, MD
• Priya Nidamanuri, MD
• Daphne Nie
• Linda Nie
• Rachel Niec, M.D., PH.D.
• Joseph Martin Nieder, M.D.
• Vincent Niederhoffer, LMT

• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.

Verify at the official NPI Registry.