Active NPI
Xenia Deans
- Dentist
- Newburgh, NY
National Provider Identifier
1407200587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 059171
- Practice address
- 147 Lake St
Newburgh, NY 12550-5263 - Phone
- (845) 563-8000
- NPI assigned
- Apr 14, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 059171 | NY | Primary |
Addresses
Primary practice location
147 Lake St
Newburgh, NY 12550-5263
Mailing address
2570 Route 9W Ste 10
Cornwall, NY 12518-1370
Phone (845) 220-3100
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181203003172 | NY | Order and Referring Only - Dentist | 5294079141 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541030400000",
"number": "1407200587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2570 ROUTE 9W STE 10",
"city": "CORNWALL",
"state": "NY",
"postal_code": "125181370",
"telephone_number": "845-220-3100",
"fax_number": "845-534-2940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 LAKE ST",
"city": "NEWBURGH",
"state": "NY",
"postal_code": "125505263",
"telephone_number": "845-563-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEANS",
"first_name": "XENIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-14",
"last_updated": "2018-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "059171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newburgh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.