Individual provider Active NPI

Boris Rubinstein, DMD

  • General Practice Dentistry
  • Feasterville Trevose, PA
National Provider Identifier
1376727891
Registry record updated Oct 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS030054L Issued in PA
Practice address
159 Forge LN
Feasterville Trevose, PA 19053-7837
Phone
(215) 431-6207
Fax
(215) 359-0841
NPI assigned
Dec 19, 2007
Last updated
Oct 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0554499 NY
General Practice Dentistry 1223G0001X DS030054L PA Primary

Addresses

Primary practice location

159 Forge LN
Feasterville Trevose, PA 19053-7837

Mailing address

2155 2ND Street Pike
Newtown, PA 18940-4126
Phone (215) 431-6207

Other identifiers 1

IdentifierTypeStateIssuer
06060915OtherDENTIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0554499NYMDGeneral Practice Dentistry
DS030054LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Chuchville Dental PLLC General Practice CurrentSince Oct 10, 2021 Accepting new patients

Organizations & group practices 2

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": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633132800000",
    "number": "1376727891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 2ND STREET PIKE",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189404126",
            "telephone_number": "215-431-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 FORGE LN",
            "city": "FEASTERVILLE TREVOSE",
            "state": "PA",
            "postal_code": "190537837",
            "telephone_number": "215-431-6207",
            "fax_number": "215-359-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBINSTEIN",
        "first_name": "BORIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-19",
        "last_updated": "2021-10-02",
        "certification_date": "2021-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0554499",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS030054L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "06060915",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Feasterville Trevose, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.