Individual provider Active NPI

Alexander Musheyev, DDS

  • Dentist
  • Bronx, NY
National Provider Identifier
1093939365
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
048493 Issued in NY
Practice address
237 Willis Ave
Bronx, NY 10454-2678
Phone
(718) 292-6311
NPI assigned
Apr 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 048493 NY Primary

Addresses

Primary practice location

237 Willis Ave
Bronx, NY 10454-2678

Mailing address

237 Willis Ave
Bronx, NY 10454-2678
Phone (718) 292-6311

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
I20200618002683 NY Practitioner - Oral SurgeryPractitioner - Interventional CardiologyPractitioner - Dentist 0547682676 Reassigns benefits to 1 organization
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Willis Dental Care, P.L.L.C. CurrentSince Sep 1, 2001 Accepting new patients

Locations

417 E 138th St
Bronx, NY 10454
Phone (917) 642-1035

134 Garth Rd
Scarsdale, NY 10583
Phone (914) 472-1555

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, 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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093939365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 WILLIS AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104542678",
            "telephone_number": "718-292-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 WILLIS AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104542678",
            "telephone_number": "718-292-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSHEYEV",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "048493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.