Individual provider Active NPI

Dena Surks, D.M.D.

  • General Practice Dentistry
  • Woodbury, NY
National Provider Identifier
1306052550
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
042444 Issued in NY
Practice address
800 Woodbury Rd
Woodbury, NY 11797-2503
Phone
(516) 364-2333
NPI assigned
May 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 042444 NY Primary

Addresses

Primary practice location

800 Woodbury Rd
Woodbury, NY 11797-2503

Mailing address

800 Woodbury Rd
Woodbury, NY 11797-2503
Phone (516) 364-2333

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.
Opted out of Medicare
Yes, effective Mar 3, 2016 through Mar 3, 2028

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160415001753 NY Order and Referring Only - DentistPractitioner - Dentist 2567760028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042444NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Prosthodontics of Woodbury 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, 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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306052550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WOODBURY RD",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972503",
            "telephone_number": "516-364-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WOODBURY RD",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972503",
            "telephone_number": "516-364-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURKS",
        "first_name": "DENA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "042444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NY

Sources for this page

Verify at the official NPI Registry.