Staten Island Oral & Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

033292 Issued in NY

Legal business name

STATEN ISLAND ORAL & MAXILLOFACIAL SURGERY

Practice address

256C Mason Ave
Staten Island, NY 10305-3408

Phone

(718) 226-1251

Fax

(718) 226-1252

NPI assigned

Jan 3, 2012

Organization subpart

No

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

Authorized official

Name

Dr. David C Hoffman, DDS

Title

President

Phone

(718) 226-1251

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Goodenough, DDS, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Staten Island, NY
  • NPI 1154858033
  Medicare reassignment Care Compare group NPD
• Lydia Jane Lam, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Staten Island, NY
  • NPI 1649542523
  Medicare reassignment Care Compare group NPD
• Jessica Li

  • Oral and Maxillofacial Surgery (Dentist)
  • Staten Island, NY
  • NPI 1194344218
  Medicare reassignment Care Compare group NPD
• Monika Patel

  • Oral and Maxillofacial Surgery (Dentist)
  • Staten Island, NY
  • NPI 1457885923
  Medicare reassignment Care Compare group NPD
• Joshua David Segal, DDS, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Brooklyn, NY
  • NPI 1154595734

  Oral and Maxillofacial Surgery

  Medicare reassignment NPD
• Mark Stein, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • New York, NY
  • NPI 1093778102
  Medicare reassignment NPD
• Steve Yusupov, DDS, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Roslyn, NY
  • NPI 1982991485
  Medicare reassignment NPD
• Christopher K Bichakjian, MD

  • MOHS-Micrographic Surgery Physician
  • Ann Arbor, MI
  • NPI 1790872539
  NPD (past)
• Leon H Kircik, MD

  • Dermatology Physician
  • Lousiville, KY
  • NPI 1760576599
  NPD (past)

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1316217763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 MASON AVE # C",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-1251",
            "fax_number": "718-226-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256C MASON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-1251",
            "fax_number": "718-226-1252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1441 South Ave Ste 707",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103143784",
            "country_code": "US",
            "telephone_number": "718-226-1251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STATEN ISLAND ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-03",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-226-1251",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "033292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.