Individual provider Active NPI

Mary R Truhlar, D.D.S.

  • General Practice Dentistry
  • Stony Brook, NY
National Provider Identifier
1215063391
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
038714-1 Issued in NY
Practice address
Stony Brook University
Stony Brook, NY 11794-8706
Phone
(631) 632-8971
NPI assigned
Feb 26, 2007
Sex
Female
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 038714-1 NY Primary

Addresses

Primary practice location

Stony Brook University
Stony Brook, NY 11794-8706

Mailing address

12 Blinkerlight Rd
Stony Brook, NY 11790-1702

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
I20151230001196 NY Order and Referring Only - DentistPractitioner - Dentist 8628370160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038714-1NYMDPharmacist

Interoperability endpoints

  • Direct secure messaging: mary.truhlar@direct.stonybrookmedicine.edu

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215063391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BLINKERLIGHT RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117901702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIVERSITY",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948706",
            "telephone_number": "631-632-8971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUHLAR",
        "first_name": "MARY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "038714-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.