Active NPI
Edmond O. Mukamal, DDS
- Dentist
- Woodmere, NY
National Provider Identifier
1295868826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 031342
- Practice address
- 150 Irving PL
Woodmere, NY 11598-1241 - Phone
- (516) 374-9100
- Fax
- (516) 374-9105
- NPI assigned
- Mar 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 031342 | NY | Primary |
Addresses
Primary practice location
150 Irving PL
Woodmere, NY 11598-1241
Mailing address
150 Irving PL
Woodmere, NY 11598-1241
Phone (516) 374-9100
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 031342 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 5D Dental PLLC | 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.
-
- Prosthodontics
- Woodmere, NY
- NPI 1346707916
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295868826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 IRVING PL",
"city": "WOODMERE",
"state": "NY",
"postal_code": "115981241",
"telephone_number": "516-374-9100",
"fax_number": "516-374-9105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 IRVING PL",
"city": "WOODMERE",
"state": "NY",
"postal_code": "115981241",
"telephone_number": "516-374-9100",
"fax_number": "516-374-9105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUKAMAL",
"first_name": "EDMOND",
"middle_name": "O.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "031342",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodmere, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.