Mitchell Jay Lipp, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

0395021 Issued in NY

Practice address

2650 Ocean Parkway
Suite 1M
Bklyn, NY 11235

Phone

(718) 769-9293

Fax

(718) 891-3718

NPI assigned

Nov 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083789903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 OCEAN PARKWAY",
            "address_2": "SUITE 1M",
            "city": "BKLYN",
            "state": "NY",
            "postal_code": "11235",
            "telephone_number": "718-769-9293",
            "fax_number": "718-891-3718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 OCEAN PARKWAY",
            "address_2": "SUITE 1M",
            "city": "BKLYN",
            "state": "NY",
            "postal_code": "11235",
            "telephone_number": "718-769-9293",
            "fax_number": "718-891-3718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPP",
        "first_name": "MITCHELL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "0395021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01059970",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine June Harvey, OTR/L
• Juana E Luster DDS PC
• Alan I Kaplan, DC
• Mark Kelman, DDS
• Fred L Lane Jr., DDS
• Alberto Luna Vega Sr., M.D.
• Mahtab Mufti, M.D.,
• Steve E Nozad, MD
• Peter J Pasqua Jr., MD
• Philip Harris MD PC

• Orthodontics and Dentofacial Orthopedics Dentistry in Bklyn, NY
• Providers in Bklyn, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.