Individual provider Active NPI

Dandline Alexandre, DMD

  • General Practice Dentistry
  • Staten Island, NY
National Provider Identifier
1295172401
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
057245 Issued in NY
Practice address
439 Port Richmond Ave
Staten Island, NY 10302-1714
Phone
(917) 830-0838
Fax
(718) 816-6507
NPI assigned
May 29, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 057245 NY Primary

Addresses

Primary practice location

439 Port Richmond Ave
Staten Island, NY 10302-1714

Mailing address

1216 Coolidge Ave
Union, NJ 07083-3721
Phone (908) 884-4811

Other practice location 1

700 Main Street
Paterson, NJ 07503
Phone (973) 754-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20190408002406 NJ Practitioner - Dentist 9133460793 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
057245NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Newark Community Health Centers, Inc CurrentSince Apr 15, 2019 Accepting new patients
Newark Community Health Centers, Inc. Current Accepting new patients

Locations

101 Ludlow St
Newark, NJ 07114
Phone (973) 565-0355

741 Broadway
Newark, NJ 07104
Phone (973) 483-1300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295172401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 COOLIDGE AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070833721",
            "telephone_number": "908-884-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 PORT RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021714",
            "telephone_number": "917-830-0838",
            "fax_number": "718-816-6507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Main Street",
            "address_purpose": "LOCATION",
            "city": "Paterson",
            "state": "NJ",
            "postal_code": "07503",
            "country_code": "US",
            "telephone_number": "973-754-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALEXANDRE",
        "first_name": "DANDLINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "057245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.