Individual provider Active NPI

Komaljit Kaur Bhasin, DDS

  • General Practice Dentistry
  • Brewster, NY
National Provider Identifier
1144312208
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
053505-1 Issued in NY
Practice address
155 Main St
Brewster, NY 10509-1521
Phone
(845) 279-6999
NPI assigned
Sep 28, 2006
Last updated
Sep 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18567 MI
General Practice Dentistry 1223G0001X 053505-1 NY Primary

Addresses

Primary practice location

155 Main St
Brewster, NY 10509-1521

Mailing address

300 Mamaroneck Ave Apt 237
White Plains, NY 10605-6412

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
I20190312002050 NY Order and Referring Only - DentistPractitioner - Dentist 0648510537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18567MIMDGeneral Practice Dentistry
053505-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505174400000",
    "number": "1144312208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MAMARONECK AVE APT 237",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106056412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MAIN ST",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105091521",
            "telephone_number": "845-279-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHASIN",
        "first_name": "KOMALJIT",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2017-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "18567",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "053505-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

Verify at the official NPI Registry.