Individual provider Active NPI

John Michael Allen, DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • New York, NY
National Provider Identifier
1396796793
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
46235 Issued in CA
Practice address
1111 Amsterdam Ave
St Lukes Division of Oral & Maxillofacial Surgery
New York, NY 10025
Phone
(212) 523-3171
Fax
(212) 523-2447
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DNF000323 GA
Dentist 122300000X 052730 NY
Dentist 122300000X 46235 CA
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 052730 NY
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 46235 CA Primary

Addresses

Primary practice location

1111 Amsterdam Ave
St Lukes Division of Oral & Maxillofacial Surgery
New York, NY 10025

Mailing address

200 W 60TH St #16a
New York, NY 10023-8506
Phone (917) 608-0868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Sep 1, 2015 through Sep 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46235CAMDMarriage & Family Therapist
DNF000323GAMDOral and Maxillofacial Surgery (Dentist)
052730NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1396796793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 60TH ST #16A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100238506",
            "telephone_number": "917-608-0868",
            "fax_number": "212-523-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "address_2": "ST LUKES DIVISION OF ORAL & MAXILLOFACIAL SURGERY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10025",
            "telephone_number": "212-523-3171",
            "fax_number": "212-523-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DNF000323",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "052730",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46235",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "052730",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "46235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.