Jonathan M Weiss, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10131-1 Issued in NY

Practice address

136 Lake St
Suite 11
Newburgh, NY 12550-5245

Phone

(845) 565-1677

Fax

(845) 565-5377

NPI assigned

Aug 30, 2007

Sex

Male

Sole proprietor

Yes

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": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1104010487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N GRAND AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033111",
            "telephone_number": "719-562-4461",
            "fax_number": "719-584-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 LAKE ST",
            "address_2": "SUITE 11",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505245",
            "telephone_number": "845-565-1677",
            "fax_number": "845-565-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "JONATHAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "10131-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY LICENSE",
            "identifier": "031081",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Onidia C Weinert, CRNA
• Marvin J Weingarten, M.D.
• Chad Weinstein, DC
• Richard G. Weintraub, O.D.
• Dorothy A Weiss, CRNA
• Katherine Wells, MA
• Yong N Wen, MD
• Wendy Keller, LCSW, LLC
• West Hudson Imaging Associates, PLLC
• John Westerman Jr., PHARMACIST

• General Practice Dentistry in Newburgh, NY
• Providers in Newburgh, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.