Organization Active NPI

Universal Dental Services of Oceanside,PC

  • General Practice Dentistry
  • Oceanside, NY
National Provider Identifier
1164519302
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
036375 Issued in NY
Legal business name
UNIVERSAL DENTAL SERVICES OF OCEANSIDE,PC
Practice address
2812 Long Beach Rd
Oceanside, NY 11572-2229
Phone
(516) 536-5340
Fax
(516) 536-5383
NPI assigned
Oct 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Joel A Bachman, DDS
Title
Dentist/Owner
Phone
(516) 536-5340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 036375 NY Primary

Addresses

Primary practice location

2812 Long Beach Rd
Oceanside, NY 11572-2229

Mailing address

2812 Long Beach Rd
Oceanside, NY 11572-2229
Phone (516) 536-5340

Other identifiers 1

IdentifierTypeStateIssuer
00752621MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164519302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 LONG BEACH RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115722229",
            "telephone_number": "516-536-5340",
            "fax_number": "516-536-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 LONG BEACH RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115722229",
            "telephone_number": "516-536-5340",
            "fax_number": "516-536-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL DENTAL SERVICES OF OCEANSIDE,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BACHMAN",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "516-536-5340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "036375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00752621",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.