Bruce J. Lish, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

045725 Issued in NY

Practice address

1122 Chestnut Ave
Brooklyn, NY 11230-5844

Phone

(718) 942-3888

Fax

(718) 942-3899

NPI assigned

Jul 17, 2006

Last updated

Mar 29, 2022By the provider in NPPES

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: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• William F Ryan Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1851328199
  Medicare reassignment NPD
• William F Ryan Community Health Center Inc

  dba Ryan Health Midtown Emotional Wellness Center

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1043079064
  NPD

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1154348712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 CHESTNUT AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305844",
            "telephone_number": "718-942-3888",
            "fax_number": "718-942-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 CHESTNUT AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305844",
            "telephone_number": "718-942-3888",
            "fax_number": "718-942-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISH",
        "first_name": "BRUCE",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Robateau & Associates LLC
• Lisan Medical Supplies, Inc
• Ellen Lischin-Smith, LCSW-C
• Cynthia S Lischner, MS, RD, CDN
• Adam J Lish, MD
• Simone Lishka, PSYD
• Anastasia Yevgenyevna Lisitsyna, MD
• Michael Lisker, L. AC.
• Olga Michele Lisker
• Gitty Lissauer

• 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 Mar 29, 2022; 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.