Individual provider Active NPI

Steve Slobodski, DDS

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1154409530
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
042886 Issued in NY
Practice address
2102 Bay Ridge Pkwy
Brooklyn, NY 11204
Phone
(718) 259-3828
Fax
(718) 837-1340
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 042886 NY Primary

Addresses

Primary practice location

2102 Bay Ridge Pkwy
Brooklyn, NY 11204

Mailing address

2102 Bay Ridge Pkwy
Brooklyn, NY 11204
Phone (718) 259-3828

Other identifiers 1

IdentifierTypeStateIssuer
01202428MedicaidNY

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
I20140909000205 NY Practitioner - Oral Surgery 7315134905 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Quiet Dental PC Dentist CurrentSince Apr 5, 2014 Accepting new patients

Locations

2102 Bay Ridge Pkwy
Brooklyn, NY 11204
Phone (718) 259-3828

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154409530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 BAY RIDGE PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11204",
            "telephone_number": "718-259-3828",
            "fax_number": "718-837-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 BAY RIDGE PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11204",
            "telephone_number": "718-259-3828",
            "fax_number": "718-837-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOBODSKI",
        "first_name": "STEVE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "042886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01202428",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.