Individual provider Active NPI

Walter William Rostkowski, D.D.S

  • General Practice Dentistry
  • Sayville, NY
National Provider Identifier
1003827742
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
043183 Issued in NY
Practice address
531 N Main St
Sayville, NY 11782-2534
Phone
(631) 589-9010
NPI assigned
Aug 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 043183 NY Primary

Addresses

Primary practice location

531 N Main St
Sayville, NY 11782-2534

Mailing address

531 N Main St
Sayville, NY 11782-2534
Phone (631) 589-9010

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
I20160121002349 NY Order and Referring Only - DentistPractitioner - Dentist 4486957693

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043183NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gentle Dentistry of Lancaster, PLLC General Practice 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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003827742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 N MAIN ST",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822534",
            "telephone_number": "631-589-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 N MAIN ST",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822534",
            "telephone_number": "631-589-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSTKOWSKI",
        "first_name": "WALTER",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "043183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayville, NY

Sources for this page

Verify at the official NPI Registry.