Active NPI
Ehud Sasson, D.D.S.
- Dentist
- Brooklyn, NY
National Provider Identifier
1154615854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 056079
- Practice address
- 9323 Avenue L
Brooklyn, NY 11236-4806 - Phone
- (718) 763-0505
- Fax
- (718) 763-1776
- NPI assigned
- May 31, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 056079 | NY | Primary |
Addresses
Primary practice location
9323 Avenue L
Brooklyn, NY 11236-4806
Mailing address
1761 Rockaway Pkwy
Brooklyn, NY 11236-4825
Phone (718) 531-9100
Other practice location 1
1761 Rockaway Pkwy
Brooklyn, NY 11236-4825
Phone (718) 531-9100
Other practice location 2
13114 Rockaway Blvd
South Ozone Park, NY 11420-2932
Phone (718) 322-9022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03818426 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150708002359 | NY | Order and Referring Only - Dentist | 9436461167 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lincoln Family Dental, PLLC | Dentist | Past | Accepting new patients |
| Lincoln Dental, P.C. | Dentist | Past | Accepting new patients |
| Harold D Weiss DDS PC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Dental Clinic/Center
- Brooklyn, NY
- NPI 1760467039
-
- Dentist
- South Ozone Park, NY
- NPI 1649259318
-
- Dentist
- South Ozone Park, NY
- NPI 1215367404
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539302400000",
"number": "1154615854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1761 ROCKAWAY PKWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112364825",
"telephone_number": "718-531-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9323 AVENUE L",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112364806",
"telephone_number": "718-763-0505",
"fax_number": "718-763-1776"
}
],
"practiceLocations": [
{
"address_1": "1761 Rockaway Pkwy",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112364825",
"country_code": "US",
"telephone_number": "718-531-9100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "13114 Rockaway Blvd",
"address_purpose": "LOCATION",
"city": "South Ozone Park",
"state": "NY",
"postal_code": "114202932",
"country_code": "US",
"telephone_number": "718-322-9022",
"fax_number": "718-322-4220",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SASSON",
"first_name": "EHUD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-31",
"last_updated": "2018-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "056079",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03818426",
"state": "NY"
}
],
"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 Oct 12, 2018; 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.