Individual provider Active NPI

Diana Marie Backer, DDS

  • Dentist
  • Rockville Centre, NY
National Provider Identifier
1023392016
Registry record updated Jan 14, 2014
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
049261 Issued in NY
Practice address
100 N Centre Ave Ste 402
Rockville Centre, NY 11570-6303
Phone
(516) 665-1335
NPI assigned
Oct 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 049261 NY Primary

Addresses

Primary practice location

100 N Centre Ave Ste 402
Rockville Centre, NY 11570-6303

Mailing address

100 N Centre Ave Ste 402
Rockville Centre, NY 11570-6303
Phone (516) 665-1335

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
I20160419000987 NY Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 9830497221

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": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1023392016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N CENTRE AVE STE 402",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115706303",
            "telephone_number": "516-665-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N CENTRE AVE STE 402",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115706303",
            "telephone_number": "516-665-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKER",
        "first_name": "DIANA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-07",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "049261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.