Individual provider Active NPI

Joseph Kam Yip, D.D.S

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1255444048
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
038125 Issued in NY
Practice address
7709 4TH Ave
Suite 1a
Brooklyn, NY 11209-3438
Phone
(718) 836-7365
Fax
(718) 836-7365
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 038125 NY Primary
General Practice Dentistry 1223G0001X 22DI02117200 NJ

Addresses

Primary practice location

7709 4TH Ave
Suite 1a
Brooklyn, NY 11209-3438

Mailing address

71 Fox Chase CT
Freehold, NJ 07728-7762
Phone (732) 294-7957

Other identifiers 1

IdentifierTypeStateIssuer
01105260MedicaidNY

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
I20160531002064 NY Order and Referring Only - DentistPractitioner - Dentist 4587954797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02117200NJMDGeneral Practice Dentistry
038125NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1255444048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 FOX CHASE CT",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077287762",
            "telephone_number": "732-294-7957",
            "fax_number": "732-294-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7709 4TH AVE",
            "address_2": "SUITE 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093438",
            "telephone_number": "718-836-7365",
            "fax_number": "718-836-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIP",
        "first_name": "JOSEPH",
        "middle_name": "KAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "038125",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02117200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01105260",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.