Michael Lance Greenbaum, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

048623 Issued in NY

Practice address

488 Great Neck Rd
3Rd Floor
Great Neck, NY 11021-4308

Phone

(516) 466-5222

Fax

(516) 466-5525

NPI assigned

May 9, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386858488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 FLORAL AVE",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118035910",
            "telephone_number": "516-932-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 GREAT NECK RD",
            "address_2": "3RD FLOOR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214308",
            "telephone_number": "516-466-5222",
            "fax_number": "516-466-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBAUM",
        "first_name": "MICHAEL",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great Neck Radiologists, PC
• Great Neck Rheumatology PLLC
• Great Neck RX Inc.
• Great Neck Vascular Surgery PC
• Shari B Green, M.D.
• Andrew Scott Greenberg, M.D.
• Burt M Greenberg, MD
• Joan Petralia Greenberg, LCSW
• Jill Greene
• Greenery Physical Therapy, P.C.

• General Practice Dentistry in Great Neck, NY
• Providers in Great Neck, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.