Individual provider Active NPI

Nozrin Laskar, DDS

  • Dentist
  • Fulton, NY
National Provider Identifier
1417578089
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02833900 Issued in NJ
Practice address
205 Oneida St
Fulton, NY 13069-1228
Phone
(315) 598-3700
NPI assigned
May 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 063673 NY
Dentist 122300000X 22DI02833900 NJ Primary

Addresses

Primary practice location

205 Oneida St
Fulton, NY 13069-1228

Mailing address

79 W Jersey St Apt 318
Elizabeth, NJ 07202-2127
Phone (201) 282-1207

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
22DI02833900NJMDDentist
063673NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Fulton Dental Health Assoc PastSince Jul 21, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1417578089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 W JERSEY ST APT 318",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072022127",
            "telephone_number": "201-282-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 ONEIDA ST",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130691228",
            "telephone_number": "315-598-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASKAR",
        "first_name": "NOZRIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-05",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063673",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02833900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.