Active NPI
Jacklyn Fisher
- Orthodontics and Dentofacial Orthopedics Dentistry
- New York, NY
National Provider Identifier
1073890778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 056727
- Practice address
- 141 E 89TH St
Apt 4J
New York, NY 10128-2318 - Phone
- (914) 629-3924
- NPI assigned
- Nov 8, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 056727 | NY | Primary |
Addresses
Primary practice location
141 E 89TH St
Apt 4J
New York, NY 10128-2318
Mailing address
141 E 89TH St
Apt 4J
New York, NY 10128-2318
Phone (914) 629-3924
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056727 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432684800000",
"number": "1073890778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 E 89TH ST",
"address_2": "APT 4J",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101282318",
"telephone_number": "914-629-3924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 E 89TH ST",
"address_2": "APT 4J",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101282318",
"telephone_number": "914-629-3924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "JACKLYN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-08",
"last_updated": "2015-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "056727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.