Individual provider Active NPI

Leslie Wilfred Seldin, DDS

  • General Practice Dentistry
  • Bronx, NY
National Provider Identifier
1063769156
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
026620 Issued in NY
Practice address
918 Pelham Pkwy S
Bronx, NY 10462-1144
Phone
(917) 834-4258
NPI assigned
Aug 8, 2012
Last updated
Aug 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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 026620 NY Primary

Addresses

Primary practice location

918 Pelham Pkwy S
Bronx, NY 10462-1144

Mailing address

15 Chester St
Brookfield, CT 06804-1503
Phone (203) 775-1377

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
026620NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1063769156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CHESTER ST",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068041503",
            "telephone_number": "203-775-1377",
            "fax_number": "203-775-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 PELHAM PKWY S",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104621144",
            "telephone_number": "917-834-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELDIN",
        "first_name": "LESLIE",
        "middle_name": "WILFRED",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-08",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "026620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.