Individual provider Active NPI

James Damascus, D.D.S.

  • General Practice Dentistry
  • Bronx, NY
National Provider Identifier
1093371700
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
061313 Issued in NY
Practice address
111 E 210TH St
Bronx, NY 10467-2401
Phone
(248) 252-6623
NPI assigned
May 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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 061313 NY Primary

Addresses

Primary practice location

111 E 210TH St
Bronx, NY 10467-2401

Mailing address

111 E 210TH St
Bronx, NY 10467-2401
Phone (248) 252-6623

Other practice location 1

4620 Leafdale Ave Apt 5
Royal Oak, MI 48073-1762
Phone (248) 252-6623 ext. 24825

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
I20240906001818 NY Practitioner - Dentist 6305386251 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
061313NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital Current Accepting new patients
Saratoga Hospital CurrentSince Aug 1, 2024 Accepting new patients
Saratoga Hospital CurrentSince Aug 1, 2024 Accepting new patients
Saratoga Hospital CurrentSince Aug 1, 2024 Accepting new patients

Locations

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

1 West Ave
Ste 300
Saratoga Springs, NY 12866
Phone (518) 693-4699

24 Hamilton St
Saratoga Springs, NY 12866
Phone (518) 886-5600

3044 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5800

Organizations & group practices 4

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": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1093371700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "248-252-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "248-252-6623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4620 Leafdale Ave Apt 5",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480731762",
            "country_code": "US",
            "telephone_number": "248-252-6623 x24825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMASCUS",
        "first_name": "JAMES",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-17",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.