NPIMap

Organization Active NPI

Long Island Oral Surgery Associates

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Syosset, NY
National Provider Identifier
1164614178
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
24574 Issued in NY
Legal business name
LONG ISLAND ORAL SURGERY ASSOCIATES
Practice address
99 Cold Spring Road
Suite 3
Syosset, NY 11791
Phone
(516) 921-2880
Fax
(516) 921-2889
NPI assigned
Aug 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Authorized official

Name
Dr. Jeffrey Alan Goldberg, D.D.S.NPI 1962484360
Title
President
Phone
(516) 921-2880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X SINGLE SPECIALTY GROUP 204E00000X 24574 NY Primary

Addresses

Primary practice location

99 Cold Spring Road
Suite 3
Syosset, NY 11791

Mailing address

99 Cold Spring Road
Suite 3
Syosset, NY 11791
Phone (516) 921-2880

Other identifiers 1

IdentifierTypeStateIssuer
DOW772OtherMEDICARE GROUP NUMBER

Other names 1

  • Long Island Center for Oral and Maxillofacial Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080620000307 NY Part B Supplier - Clinic/Group Practice 4880584820 Receives reassigned benefits from 4 practitioners
Practice locations: Franklin Square, NY; Syosset, NY; Westbury, NY

National Provider Directory

National Provider Directory
Tax ID family
Long Island Center for Oral5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

393 Franklin Ave
Ste 102
Franklin Square, NY 11010
Phone (516) 437-9600

99 Cold Spring Rd
Ste 103
Syosset, NY 11791
Phone (516) 921-2880

175 Jericho Tpke
Ste 305
Syosset, NY 11791
Phone (516) 921-2880

99 Cold Spring Rd
Ste 3
Syosset, NY 11791
Phone (516) 921-2880

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493856000000",
    "number": "1164614178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 COLD SPRING ROAD",
            "address_2": "SUITE 3",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "11791",
            "telephone_number": "516-921-2880",
            "fax_number": "516-921-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 COLD SPRING ROAD",
            "address_2": "SUITE 3",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "11791",
            "telephone_number": "516-921-2880",
            "fax_number": "516-921-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND ORAL SURGERY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2017-05-04",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-921-2880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "24574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "DOW772",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Island Center for Oral and Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.