Individual provider Active NPI

Faina W Bram, DENTIST

  • General Practice Dentistry
  • Bayside, NY
National Provider Identifier
1073688578
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
04697 Issued in NY
Practice address
3534 Bell Blvd
Bayside, NY 11361
Phone
(718) 229-3232
Fax
(576) 229-5655
NPI assigned
Nov 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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
General Practice Dentistry 1223G0001X 04697 NY Primary

Addresses

Primary practice location

3534 Bell Blvd
Bayside, NY 11361

Mailing address

9 Sagamore Drive
Plainview, NY 11803
Phone (516) 692-4099

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160411001264 NY Order and Referring Only - DentistPractitioner - Dentist 3971801838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04697NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073688578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 SAGAMORE DRIVE",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "11803",
            "telephone_number": "516-692-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3534 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11361",
            "telephone_number": "718-229-3232",
            "fax_number": "576-229-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAM",
        "first_name": "FAINA",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DENTIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "04697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.