Individual provider Active NPI

John Edward Dinan Jr., DMD, MS

  • Orofacial Pain Dentistry
  • New York, NY
National Provider Identifier
1093054157
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
062947-01 Issued in NY
Practice address
630 Fifth Ave
Suite 1857
New York, NY 10111-1868
Phone
(212) 969-9166
Fax
(212) 265-1767
NPI assigned
Feb 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orofacial Pain Dentistry 1223X2210X 22DI02542300 NJ
Orofacial Pain Dentistry 1223X2210X 062947-01 NY Primary

Addresses

Primary practice location

630 Fifth Ave
Suite 1857
New York, NY 10111-1868

Mailing address

630 Fifth Ave
Suite 1857
New York, NY 10111-1868
Phone (212) 969-9166

Other practice location 1

901 Mountain Ave Ste Sc13
Springfield, NJ 07081-3414
Phone (212) 969-9166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Sep 1, 2023 through Sep 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
22DI02542300NJMDOrofacial Pain Dentist
062947-01NYMDOrofacial Pain Dentist
062947NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lauren Levi, D.M.D., P.C. General Practice CurrentSince Feb 11, 2024 Accepting new patients
Asnis Dental, PLLC PastSince Feb 11, 2024 Accepting new patients

Locations

630 5th Ave
Ste 1857
New York, NY 10111
Phone (212) 265-0110

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1360454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1093054157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 FIFTH AVE",
            "address_2": "SUITE 1857",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101111868",
            "telephone_number": "212-969-9166",
            "fax_number": "212-265-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 FIFTH AVE",
            "address_2": "SUITE 1857",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101111868",
            "telephone_number": "212-969-9166",
            "fax_number": "212-265-1767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Mountain Ave Ste Sc13",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "NJ",
            "postal_code": "070813414",
            "country_code": "US",
            "telephone_number": "212-969-9166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DINAN",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-10",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "NJ",
            "license": "22DI02542300",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "NY",
            "license": "062947-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.