Individual provider Active NPI

Bruce Evan Howard, D.D.S.

  • General Practice Dentistry
  • Smithtown, NY
National Provider Identifier
1427114289
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29242 Issued in NY
Practice address
267 E Main St
Suite B2
Smithtown, NY 11787-2874
Phone
(631) 724-0343
Fax
(631) 724-3179
NPI assigned
Dec 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 29242 NY Primary

Addresses

Primary practice location

267 E Main St
Suite B2
Smithtown, NY 11787-2874

Mailing address

267 E Main St
Suite B2
Smithtown, NY 11787-2874
Phone (631) 724-0343

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150525000001 NY Order and Referring Only - DentistPractitioner - Dentist 6406176981

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29242NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427114289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 E MAIN ST",
            "address_2": "SUITE B2",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872874",
            "telephone_number": "631-724-0343",
            "fax_number": "631-724-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 E MAIN ST",
            "address_2": "SUITE B2",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872874",
            "telephone_number": "631-724-0343",
            "fax_number": "631-724-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "BRUCE",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "29242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.