Individual provider Active NPI

Susan Coven, D.D.S.

  • Periodontics
  • Great Neck, NY
National Provider Identifier
1003218421
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
036475 Issued in NY
Practice address
29 Barstow Rd
105
Great Neck, NY 11021-2222
Phone
(516) 466-3611
Fax
(516) 466-9398
NPI assigned
Sep 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 036475 NY Primary

Addresses

Primary practice location

29 Barstow Rd
105
Great Neck, NY 11021-2222

Mailing address

29 Barstow Rd
105
Great Neck, NY 11021-2222
Phone (516) 466-3611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot L. Auerbach, DDS, PC Periodontics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1003218421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 BARSTOW RD",
            "address_2": "105",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212222",
            "telephone_number": "516-466-3611",
            "fax_number": "516-466-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 BARSTOW RD",
            "address_2": "105",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212222",
            "telephone_number": "516-466-3611",
            "fax_number": "516-466-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVEN",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "036475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.