Individual provider Active NPI

Bernard Fialkoff, DDS

  • Periodontics
  • Oakland Gardens, NY
National Provider Identifier
1194874537
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DS36438 Issued in NY
Practice address
5603 214TH St
Oakland Gardens, NY 11364-1845
Phone
(718) 229-3838
Fax
(718) 229-0239
NPI assigned
Jan 8, 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
Periodontics 1223P0300X DS36438 NY Primary

Addresses

Primary practice location

5603 214TH St
Oakland Gardens, NY 11364-1845

Mailing address

5603 214TH St
Oakland Gardens, NY 11364-1845
Phone (718) 229-3838

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
I20151106001596 NY Order and Referring Only - DentistPractitioner - Dentist 6204146012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS36438NYMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194874537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5603 214TH ST",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113641845",
            "telephone_number": "718-229-3838",
            "fax_number": "718-229-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5603 214TH ST",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113641845",
            "telephone_number": "718-229-3838",
            "fax_number": "718-229-0239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIALKOFF",
        "first_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "DS36438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Gardens, NY

Sources for this page

Verify at the official NPI Registry.