Individual provider Active NPI

Jonathan Dov Hochbaum

  • Dentist
  • Middletown, NY
National Provider Identifier
1003305665
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
060766 Issued in NY
Practice address
225 Dolson Ave Ste 202
Middletown, NY 10940-6570
Phone
(845) 343-1486
NPI assigned
May 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 060766 NY Primary

Addresses

Primary practice location

225 Dolson Ave Ste 202
Middletown, NY 10940-6570

Mailing address

686 Evergreen Dr
West Hempstead, NY 11552-3407
Phone (516) 993-5178

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

State licenses

LicenseStateTypeSpecialty
060766NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Dental Associates Dentist CurrentSince Jul 12, 2020 Accepting new patients

Locations

225 Dolson Ave
Ste 202
Middletown, NY 10940
Phone (845) 343-1486

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1003305665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 EVERGREEN DR",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115523407",
            "telephone_number": "516-993-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 DOLSON AVE STE 202",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109406570",
            "telephone_number": "845-343-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOCHBAUM",
        "first_name": "JONATHAN",
        "middle_name": "DOV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "060766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.