Individual provider Active NPI

Andrew S Breiman, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Yonkers, NY
National Provider Identifier
1073683330
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
50-031496 Issued in NY
Practice address
73 Market Street
Suite 377
Yonkers, NY 10710
Phone
(914) 779-5606
Fax
(914) 968-2474
NPI assigned
Nov 8, 2006
Last updated
Dec 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 031496 NY
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 50-031496 NY Primary

Addresses

Primary practice location

73 Market Street
Suite 377
Yonkers, NY 10710

Mailing address

73 Market Street
Suite 377
Yonkers, NY 10710
Phone (914) 779-5606

Other identifiers 1

IdentifierTypeStateIssuer
00678024-ETIN-AJ19MedicaidNY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
50-031496NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Oral Surgery Alliance of Downstate New York PLLC Oral and Maxillofacial Surgery PastSince Feb 1, 2017 Accepting new patients

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1073683330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 MARKET STREET",
            "address_2": "SUITE 377",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "10710",
            "telephone_number": "914-779-5606",
            "fax_number": "914-968-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 MARKET STREET",
            "address_2": "SUITE 377",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "10710",
            "telephone_number": "914-779-5606",
            "fax_number": "914-968-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREIMAN",
        "first_name": "ANDREW",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "031496",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "50-031496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00678024-ETIN-AJ19",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.