Ismael Bastida, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

052687 Issued in NY

Practice address

4014 82ND St
Elmhurst, NY 11373-1305

Phone

(718) 397-7777

NPI assigned

Aug 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New York Dental Services PLLC

  • Dentist
  • Elmhurst, NY
  • NPI 1467937722
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1073526505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 82ND ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731305",
            "telephone_number": "718-397-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 82ND ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731305",
            "telephone_number": "718-397-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIDA",
        "first_name": "ISMAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ian Enrick Bartolome
• Susmita Barua, PA
• Jair Fernando Basantes de la Calle, MD
• Sita Basnet
• Mohamed Bassiony, MD
• Jason Alexander Bastida, DDS
• Abdullah Ziad Bataineh
• Nicolle Marie Batlle, MD
• Nuzhat Batool
• Zohra Batool, PA

• General Practice Dentistry in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.