Individual provider Active NPI

Jean Edouard Fayette, D.D.S.

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1154597243
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
045000 Issued in NY
Practice address
456 Schenectady Ave
Ap#1P
Brooklyn, NY 11203-1353
Phone
(718) 953-7639
Fax
(718) 363-5927
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2008

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 045000 NY Primary

Addresses

Primary practice location

456 Schenectady Ave
Ap#1P
Brooklyn, NY 11203-1353

Mailing address

456 Schenectady Ave.
Ap#1P
Brooklyn, NY 11203
Phone (718) 953-7639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1154597243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 SCHENECTADY AVE.",
            "address_2": "AP#1P",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11203",
            "telephone_number": "718-953-7639",
            "fax_number": "718-363-5927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 SCHENECTADY AVE",
            "address_2": "AP#1P",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031353",
            "telephone_number": "718-953-7639",
            "fax_number": "718-363-5927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYETTE",
        "first_name": "JEAN",
        "middle_name": "EDOUARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.