NPIMap

Individual provider Active NPI

Jonathan Friedman

  • Dentist
  • Far Rockaway, NY
National Provider Identifier
1114360179
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
057281 Issued in NY
Practice address
1145 Sage St
Far Rockaway, NY 11691-4820
Phone
(718) 757-9915
NPI assigned
Apr 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 057281 NY Primary

Addresses

Primary practice location

1145 Sage St
Far Rockaway, NY 11691-4820

Mailing address

1145 Sage St
Far Rockaway, NY 11691-4820
Phone (718) 757-9915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
057281NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Samet and Friedman Dental Group PLLC Dentist Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jonathan.friedmandds.p1@direct.ezramedical.nextgenshare.com

Organizations & group practices 1

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": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1114360179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 SAGE ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914820",
            "telephone_number": "718-757-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 SAGE ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914820",
            "telephone_number": "718-757-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-09",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; 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.