Individual provider Active NPI

Jeffrey Lazarus, DDS

  • Dentist
  • Monroe, NY
National Provider Identifier
1083355572
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
063350 Issued in NY
Practice address
3 Center Hill Rd
Monroe, NY 10950-4805
Phone
(845) 783-1311
NPI assigned
Apr 6, 2022
Last updated
Aug 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 063350 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

3 Center Hill Rd
Monroe, NY 10950-4805

Mailing address

33 S Parker Dr
Monsey, NY 10952-1604
Phone (845) 596-2349

Other practice location 1

728 N Main St
New Square, NY 10977-8916
Phone (845) 354-9300

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
063350NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Exceldent Dental of Monroe, LLP PastSince Sep 5, 2023 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": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1083355572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 S PARKER DR",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109521604",
            "telephone_number": "845-596-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CENTER HILL RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109504805",
            "telephone_number": "845-783-1311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "728 N Main St",
            "address_purpose": "LOCATION",
            "city": "New Square",
            "state": "NY",
            "postal_code": "109778916",
            "country_code": "US",
            "telephone_number": "845-354-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZARUS",
        "first_name": "JEFFREY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-06",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063350",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.