Individual provider Active NPI

William G Bast, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Hartsdale, NY
National Provider Identifier
1063543650
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
045376 Issued in NY
Practice address
280 N Central Ave Ste 307
Hartsdale, NY 10530-1839
Phone
(914) 997-7688
NPI assigned
Mar 8, 2007
Last updated
May 18, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 045376 NY Primary

Addresses

Primary practice location

280 N Central Ave Ste 307
Hartsdale, NY 10530-1839

Mailing address

27 Hospital Ave Ste 306
Danbury, CT 06810-5961
Phone (203) 628-4450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Nov 15, 2019 through Nov 15, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045376NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Implant & Oral Surgery, PC CurrentSince Feb 1, 2007 Accepting new patients

Locations

27 Hospital Ave
Ste 306
Danbury, CT 06810
Phone (203) 797-0008

667 Stoneleigh Ave
Ste 301
Carmel, NY 10512
Phone (845) 278-2101

666 Lexington Ave
Ste 203
Mount Kisco, NY 10549
Phone (203) 797-0008

43 Lagrange Ave
Poughkeepsie, NY 12603
Phone (845) 452-2900

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1063543650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 HOSPITAL AVE STE 306",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105961",
            "telephone_number": "203-628-4450",
            "fax_number": "203-628-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 N CENTRAL AVE STE 307",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301839",
            "telephone_number": "914-997-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAST",
        "first_name": "WILLIAM",
        "middle_name": "G",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "045376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsdale, NY

Sources for this page

Verify at the official NPI Registry.