Individual provider Active NPI

Heba Loutfy, D.M.D

  • General Practice Dentistry
  • Staten Island, NY
National Provider Identifier
1245462035
Registry record updated Mar 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
054574 Issued in NY
Practice address
22 Albert St
Staten Island, NY 10301-4102
Phone
(718) 273-1849
NPI assigned
Aug 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2012

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 054574 NY Primary

Addresses

Primary practice location

22 Albert St
Staten Island, NY 10301-4102

Mailing address

22 Albert St
Staten Island, NY 10301-4102

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
I20160105001115 NY Order and Referring Only - DentistPractitioner - Dentist 5799087961

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1245462035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 ALBERT ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 ALBERT ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014102",
            "telephone_number": "718-273-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUTFY",
        "first_name": "HEBA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.