Individual provider Active NPI

Christopher Joseph Lane, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • White Plains, NY
National Provider Identifier
1205802345
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
042192 Issued in NY
Practice address
95 Church St
Suite 404
White Plains, NY 10601-1515
Phone
(914) 946-1249
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 042192 NY Primary

Addresses

Primary practice location

95 Church St
Suite 404
White Plains, NY 10601-1515

Mailing address

95 Church St
Suite 404
White Plains, NY 10601-1515
Phone (914) 946-1249

Other identifiers 1

IdentifierTypeStateIssuer
01455985MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100521000852 NY Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 6204965767 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Barnabas Hospital Oral and Maxillofacial Surgery CurrentSince Jan 1, 2022 Accepting new patients
St. Barnabas Hospital CurrentSince Jan 1, 2022 Accepting new patients
St. Barnabas Hospital Past Accepting new patients
Lighthouse International Past Accepting new patients

Locations

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236

2021 Grand Concourse
Bronx, NY 10453
Phone (718) 299-2800

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: clane18492@sbhny.direct-ci.net

Organizations & group practices 5

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1205802345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 CHURCH ST",
            "address_2": "SUITE 404",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106011515",
            "telephone_number": "914-946-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 CHURCH ST",
            "address_2": "SUITE 404",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106011515",
            "telephone_number": "914-946-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "042192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01455985",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.