Individual provider Active NPI

Harry Dym, D.D.S.

  • Oral and Maxillofacial Pathology Dentistry
  • Brooklyn, NY
National Provider Identifier
1366538910
Registry record updated Feb 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
036617 Issued in NY
Practice address
1001 E 29TH St
Brooklyn, NY 11210-3750
Phone
(718) 377-5668
Fax
(718) 377-4545
NPI assigned
Oct 4, 2006
Last updated
Feb 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 036617 NY Primary

Addresses

Primary practice location

1001 E 29TH St
Brooklyn, NY 11210-3750

Mailing address

1001 E 29TH St
Brooklyn, NY 11210-3750
Phone (718) 377-5668

Other identifiers 1

IdentifierTypeStateIssuer
00956721MedicaidNY

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
I20180308001827 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4880873868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036617NYMDOral and Maxillofacial Pathology Dentist

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: hdym562993@nychhc.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Brooklyn Hospital CenterBrooklyn, NY, CCN 330056 Hospital Corporate Director Dec 1, 2010
The Brooklyn Hospital CenterBrooklyn, NY, CCN 33T056 Hospital Corporate Director Dec 1, 2010

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1366538910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E 29TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112103750",
            "telephone_number": "718-377-5668",
            "fax_number": "718-377-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E 29TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112103750",
            "telephone_number": "718-377-5668",
            "fax_number": "718-377-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYM",
        "first_name": "HARRY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": "036617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00956721",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.