Abraham Dyzenhaus, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

039914 Issued in NY

Practice address

8409 35TH Ave
Apt 1-F
Jackson Heights, NY 11372-5454

Phone

(718) 446-3219

Fax

(718) 446-8598

NPI assigned

Jan 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Networks

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

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

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386797371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8409 35TH AVE",
            "address_2": "APT 1-F",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113725454",
            "telephone_number": "718-446-3219",
            "fax_number": "718-446-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8409 35TH AVE",
            "address_2": "APT 1-F",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113725454",
            "telephone_number": "718-446-3219",
            "fax_number": "718-446-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYZENHAUS",
        "first_name": "ABRAHAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "039914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Carlos Dumas, LMHC
• Mario Duque, DC
• Yomira Duran
• Dxi Jackson Heights Inc.
• Schontasha Dyce
• E & J Medical P.C.
• Shiny Easo, N.P.
• Eastern Park Medical Services,P.C.
• Easy Care Queens Medical, PC
• Susanna Eckblad, LCSW

• General Practice Dentistry in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.