Individual provider Active NPI

Robert Steven Popkin, DMD MAGD

  • General Practice Dentistry
  • Port Washington, NY
National Provider Identifier
1417181017
Registry record updated Sep 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
042733 Issued in NY
Practice address
14 Vanderventer Ave
Port Washington, NY 11050-3737
Phone
(516) 767-3658
NPI assigned
May 11, 2009
Last updated
Sep 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 042733 NY
Public Health Dentistry 1223D0001X 042733 NY
General Practice Dentistry 1223G0001X 042733 NY Primary

Addresses

Primary practice location

14 Vanderventer Ave
Port Washington, NY 11050-3737

Mailing address

14 Vanderventer Ave
Port Washington, NY 11050-3737
Phone (516) 767-3658

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
042733NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253750400000",
    "number": "1417181017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 VANDERVENTER AVE",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503737",
            "telephone_number": "516-767-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 VANDERVENTER AVE",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503737",
            "telephone_number": "516-767-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPKIN",
        "first_name": "ROBERT",
        "middle_name": "STEVEN",
        "credential": "DMD  MAGD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-11",
        "last_updated": "2009-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "042733",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NY",
            "license": "042733",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "042733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2009; 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.