Individual provider Active NPI

Marc A Berstein, DDS

  • Dentist
  • Great Neck, NY
National Provider Identifier
1225184112
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
030469 Issued in NY
Practice address
75 South Middle Neck Road
Great Neck, NY 11021-3445
Phone
(516) 482-6572
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

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
Dentist 122300000X 030469 NY Primary

Addresses

Primary practice location

75 South Middle Neck Road
Great Neck, NY 11021-3445

Mailing address

75 South Middle Neck Road
Great Neck, NY 11021-3445
Phone (516) 482-6572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
030469NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225184112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 SOUTH MIDDLE NECK ROAD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213445",
            "telephone_number": "516-482-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SOUTH MIDDLE NECK ROAD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213445",
            "telephone_number": "516-482-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERSTEIN",
        "first_name": "MARC",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "030469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.