Active NPI
Jennifer Mackey, DDS
- Dentist
- Medford, NY
National Provider Identifier
1235571423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 50056771
- Practice address
- 1739 N Ocean Ave
Ste D
Medford, NY 11763-2683 - Phone
- (631) 447-8073
- NPI assigned
- Jul 29, 2013
- Last updated
- Jul 29, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 50056771 | NY | Primary |
Addresses
Primary practice location
1739 N Ocean Ave
Ste D
Medford, NY 11763-2683
Mailing address
1739 N Ocean Ave
Ste D
Medford, NY 11763-2683
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
| License | State | Type | Specialty |
|---|---|---|---|
| 50056771 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raio Dental, PC | 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.
-
- General Practice Dentistry
- Medford, NY
- NPI 1629365846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375056000000",
"number": "1235571423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1739 N OCEAN AVE",
"address_2": "STE D",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117632683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1739 N OCEAN AVE",
"address_2": "STE D",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117632683",
"telephone_number": "631-447-8073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKEY",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-29",
"last_updated": "2013-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "50056771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.