Individual provider Active NPI

Steven Joseph Bizzell, D.M.D.

  • Periodontics
  • New York, NY
National Provider Identifier
1053498709
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
047045 Issued in NY
Practice address
40 W 72ND St
New York, NY 10023-4119
Phone
(212) 362-3720
Fax
(212) 362-3725
NPI assigned
Nov 1, 2006
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
Periodontics 1223P0300X 047045 NY Primary

Addresses

Primary practice location

40 W 72ND St
New York, NY 10023-4119

Mailing address

40 W 72ND St
New York, NY 10023-4119
Phone (212) 362-3720

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
047045NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053498709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W 72ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100234119",
            "telephone_number": "212-362-3720",
            "fax_number": "212-362-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 W 72ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100234119",
            "telephone_number": "212-362-3720",
            "fax_number": "212-362-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIZZELL",
        "first_name": "STEVEN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "047045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.