Individual provider Active NPI

Leonard Irwin Berkowitz, D.D.S.

  • General Practice Dentistry
  • Dix Hills, NY
National Provider Identifier
1346239688
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
030656 Issued in NY
Practice address
3 Chablis Dr
Dix Hills, NY 11746-5834
Phone
(631) 673-6096
Fax
(631) 549-1026
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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 030656 NY Primary

Addresses

Primary practice location

3 Chablis Dr
Dix Hills, NY 11746-5834

Mailing address

3 Chablis Dr
Dix Hills, NY 11746-5834
Phone (631) 673-6096

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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151120000334 NY Order and Referring Only - DentistPractitioner - Dentist 9234439498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030656NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Manisha Suri DDS PC 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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1346239688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CHABLIS DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465834",
            "telephone_number": "631-673-6096",
            "fax_number": "631-549-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CHABLIS DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465834",
            "telephone_number": "631-673-6096",
            "fax_number": "631-549-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKOWITZ",
        "first_name": "LEONARD",
        "middle_name": "IRWIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "030656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.