Individual provider Active NPI

Harvey Lindenbaum, DDS

  • General Practice Dentistry
  • Middle Island, NY
National Provider Identifier
1154556322
Registry record updated May 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
029544 Issued in NY
Practice address
770 Middle Country Rd
Middle Island, NY 11953-2555
Phone
(631) 924-7997
Fax
(631) 924-7953
NPI assigned
May 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 029544 NY Primary

Addresses

Primary practice location

770 Middle Country Rd
Middle Island, NY 11953-2555

Mailing address

770 Middle Country Rd
Middle Island, NY 11953-2555
Phone (631) 924-7997

Other identifiers 1

IdentifierTypeStateIssuer
00407805MedicaidNY

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
I20150611002313 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8729309083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029544NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Island Dental Works Past Accepting new patients
Alan Ellman - Harvey Lindenbaum DDS Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242604800000",
    "number": "1154556322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 MIDDLE COUNTRY RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532555",
            "telephone_number": "631-924-7997",
            "fax_number": "631-924-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 MIDDLE COUNTRY RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532555",
            "telephone_number": "631-924-7997",
            "fax_number": "631-924-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDENBAUM",
        "first_name": "HARVEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-18",
        "last_updated": "2009-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "029544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00407805",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Island, NY

Sources for this page

Verify at the official NPI Registry.