Individual provider Active NPI

Itzhak Eisinger, DDS

  • Dentist
  • Forest Hills, NY
National Provider Identifier
1174790992
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41399 Issued in NY
Practice address
110-50 71St Rd
Suite 1-O
Forest Hills, NY 11375
Phone
(718) 268-5080
Fax
(718) 268-5081
NPI assigned
May 12, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 41399 NY Primary

Addresses

Primary practice location

110-50 71St Rd
Suite 1-O
Forest Hills, NY 11375

Mailing address

110-50 71St Rd
Suite 1-O
Forest Hills, NY 11375
Phone (718) 268-5080

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
I20160524001153 NY Order and Referring Only - DentistPractitioner - Dentist 9032408448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41399NYMDDentist
041399NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1174790992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110-50 71ST RD",
            "address_2": "SUITE 1-O",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-268-5080",
            "fax_number": "718-268-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110-50 71ST RD",
            "address_2": "SUITE 1-O",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-268-5080",
            "fax_number": "718-268-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISINGER",
        "first_name": "ITZHAK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "41399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.