Individual provider Active NPI

Alan Rosen, D.D.S.

  • General Practice Dentistry
  • Cedarhurst, NY
National Provider Identifier
1194853416
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
036816 Issued in NY
Practice address
650 Central Ave Ste O
Cedarhurst, NY 11516-2301
Phone
(516) 569-2666
NPI assigned
Feb 28, 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 036816 NY Primary

Addresses

Primary practice location

650 Central Ave Ste O
Cedarhurst, NY 11516-2301

Mailing address

650 Central Ave Ste O
Cedarhurst, NY 11516-2301
Phone (516) 569-2666

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
I20150603001860 NY Order and Referring Only - DentistPractitioner - Dentist 2769703628

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036816NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194853416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 CENTRAL AVE STE O",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162301",
            "telephone_number": "516-569-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 CENTRAL AVE STE O",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162301",
            "telephone_number": "516-569-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "036816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarhurst, NY

Sources for this page

Verify at the official NPI Registry.