Individual provider Active NPI

Saul Schwalb, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1174739114
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
038195 Issued in NY
Practice address
662 Bedford Ave
Brooklyn, NY 11211-8017
Phone
(718) 624-6363
Fax
(718) 875-7446
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 038195 NY Primary

Addresses

Primary practice location

662 Bedford Ave
Brooklyn, NY 11211-8017

Mailing address

662 Bedford Ave
Brooklyn, NY 11211-8017
Phone (718) 624-6363

Other identifiers 1

IdentifierTypeStateIssuer
00814131MedicaidNY

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

State licenses

LicenseStateTypeSpecialty
038195NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174739114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "662 BEDFORD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112118017",
            "telephone_number": "718-624-6363",
            "fax_number": "718-875-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "662 BEDFORD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112118017",
            "telephone_number": "718-624-6363",
            "fax_number": "718-875-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWALB",
        "first_name": "SAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "038195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00814131",
            "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 Jul 8, 2007; 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.