Organization Active NPI

Merrick Oral Surgery PLLC

  • Oral and Maxillofacial Pathology Dentistry
  • Merrick, NY
National Provider Identifier
1265520399
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
Legal business name
MERRICK ORAL SURGERY PLLC
Practice address
2116 Merrick Ave
Suite 4008
Merrick, NY 11566
Phone
(516) 546-1444
Fax
(516) 546-5576
NPI assigned
Oct 11, 2006
Last updated
Dec 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Authorized official

Name
Dr. Steven M Dabundo, DDSNPI 1225064611
Title
Owner
Phone
(516) 546-1444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0106X NY Primary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X NY

Addresses

Primary practice location

2116 Merrick Ave
Suite 4008
Merrick, NY 11566

Mailing address

2116 Merrick Ave Suite 4008.
Merrick, NY 11566
Phone (516) 546-1444

Other identifiers 1

IdentifierTypeStateIssuer
00389937MedicaidNY

Other names 1

  • DRS. Garfield & Kramer Former legal business name

National Provider Directory

National Provider Directory

Locations

2116 Merrick Ave
Ste 4008
Merrick, NY 11566
Phone (516) 546-1444

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449532800000",
    "number": "1265520399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 MERRICK AVE SUITE 4008.",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "11566",
            "telephone_number": "516-546-1444",
            "fax_number": "516-546-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 MERRICK AVE",
            "address_2": "SUITE 4008",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "11566",
            "telephone_number": "516-546-1444",
            "fax_number": "516-546-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRICK ORAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2015-12-08",
        "status": "A",
        "authorized_official_last_name": "DABUNDO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-546-1444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00389937",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DRS. Garfield & Kramer",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Merrick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; 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.