Edward M Bram, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

028430 Issued in NY

Practice address

2233 Nesconset Hwy
Suite 101
Lake Grove, NY 11755-1000

Phone

(631) 588-3636

Fax

(631) 588-3637

NPI assigned

Aug 15, 2006

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

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 Nov 5, 2015 through Nov 5, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Smith Haven Dentistry, PLLC

  • Dental Clinic/Center
  • Lake Grove, NY
  • NPI 1144608936
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114930666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 NESCONSET HWY",
            "address_2": "SUITE 101",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551000",
            "telephone_number": "631-588-3636",
            "fax_number": "631-588-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 NESCONSET HWY",
            "address_2": "SUITE 101",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551000",
            "telephone_number": "631-588-3636",
            "fax_number": "631-588-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAM",
        "first_name": "EDWARD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "028430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann Biamonte, OT REGISTERED
• Jacques S. J. Blanchard, D.P.T.,
• Marcia Blatt, MA
• Robert Joseph Boswell, MD
• Mario Brajuha, LMSW
• Robert Branca, DDS
• Dawn P Brauer, M.S.P.T., C.I.M.I.
• Andrew Zotos Breslin, LMSW
• Brian K. Berliner, O.D., P.C.
• Patricia J Brims, PA-C

• General Practice Dentistry in Lake Grove, NY
• Providers in Lake Grove, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.