Individual provider Active NPI

Ehud Sasson, D.D.S.

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1154615854
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
056079 Issued in NY
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

Updated by the provider on Oct 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
03818426MedicaidNY

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
I20150708002359 NY Order and Referring Only - DentistPractitioner - Dentist 9436461167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.