Jack Irwin, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

033918 Issued in NY

Practice address

414 7TH Ave
Brooklyn, NY 11215-5052

Phone

(718) 768-8372

Fax

(718) 788-8948

NPI assigned

Jun 17, 2005

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1154326957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 7TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155052",
            "telephone_number": "718-768-8372",
            "fax_number": "718-788-8948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 7TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155052",
            "telephone_number": "718-768-8372",
            "fax_number": "718-788-8948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "033918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pauline Federeika Irving, LPN.
• Irvington Healthcare Providers LLC
• Irwin Goldschein DDS PC
• Irwin Kolin, DDS
• Irwin L Azar DDS PC
• Mark B Irwin, M.D.
• Mitch Irwin, M.S., SLP-CFY
• Raeanne Irwin, LPN
• Shameka Irwin
• Jahangir Iryami

• General Practice Dentistry in Brooklyn, NY
• Providers in Brooklyn, 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 Aug 28, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.