Individual provider Active NPI

Edward J Sutton, DDS

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1285619585
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
030491 Issued in NY
Practice address
1636 E 14TH St
Suite 114
Brooklyn, NY 11229-1100
Phone
(718) 998-9700
Fax
(718) 998-7592
NPI assigned
Dec 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 030491 NY Primary

Addresses

Primary practice location

1636 E 14TH St
Suite 114
Brooklyn, NY 11229-1100

Mailing address

1956 Ocean Pkwy
Brooklyn, NY 11223-3057
Phone (718) 998-9700

Other identifiers 1

IdentifierTypeStateIssuer
0135383MedicaidNY

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

Practice roles

OrganizationSpecialtyStatusNew patients
Graham Dental Associates PC Dentist 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1285619585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1956 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112233057",
            "telephone_number": "718-998-9700",
            "fax_number": "718-998-7592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 E 14TH ST",
            "address_2": "SUITE 114",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291100",
            "telephone_number": "718-998-9700",
            "fax_number": "718-998-7592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "030491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0135383",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.