Individual provider Active NPI

Brian M Okeefe, DMD

  • General Practice Dentistry
  • East Setauket, NY
National Provider Identifier
1376565671
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38919 Issued in NY
Practice address
200 Main St
East Setauket, NY 11733-2918
Phone
(631) 751-3993
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

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 38919 NY Primary

Addresses

Primary practice location

200 Main St
East Setauket, NY 11733-2918

Mailing address

200 Main St
East Setauket, NY 11733-2918
Phone (631) 751-3993

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
I20150710000460 NY Order and Referring Only - DentistPractitioner - Dentist 5799097366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38919NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376565671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MAIN ST",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332918",
            "telephone_number": "631-751-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAIN ST",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332918",
            "telephone_number": "631-751-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEEFE",
        "first_name": "BRIAN",
        "middle_name": "M",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "38919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.