Individual provider Active NPI

Stanley J Boyd, DMD

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1194860635
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
039008 Issued in NY
Practice address
720 Greenwich St
Apt #5N
New York, NY 10014-2545
Phone
(212) 633-8292
Fax
(212) 206-1232
NPI assigned
Feb 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 039008 NY Primary

Addresses

Primary practice location

720 Greenwich St
Apt #5N
New York, NY 10014-2545

Mailing address

77 W 15TH St
New York, NY 10011-6840
Phone (212) 206-0513

Other identifiers 1

IdentifierTypeStateIssuer
39008OtherNYLICENSE

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
I20160406000271 NY Order and Referring Only - DentistPractitioner - Dentist 0143528265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039008NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Chelsea Dental, P.C Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194860635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W 15TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116840",
            "telephone_number": "212-206-0513",
            "fax_number": "212-206-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 GREENWICH ST",
            "address_2": "APT #5N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100142545",
            "telephone_number": "212-633-8292",
            "fax_number": "212-206-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "STANLEY",
        "middle_name": "J",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "039008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "39008",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.