Eastside Oral Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

047259 Issued in NY

Legal business name

EASTSIDE ORAL SURGERY

Practice address

231 E 106TH St
New York, NY 10029-4005

Phone

(212) 348-0020

Fax

(646) 219-2039

NPI assigned

Sep 22, 2009

Organization subpart

No

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

Authorized official

Name

Adam S Brisman, D.M.D

Title

Owner

Phone

(212) 348-0020

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253577600000",
    "number": "1427382563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 E 106TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294005",
            "telephone_number": "212-348-0020",
            "fax_number": "646-219-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 E 106TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294005",
            "telephone_number": "212-348-0020",
            "fax_number": "646-219-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-22",
        "last_updated": "2009-09-22",
        "status": "A",
        "authorized_official_last_name": "BRISMAN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-348-0020",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "047259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02249521",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastside Medical Care PLLC
• Eastside Medical Office , PC
• Eastside Medical Practice, P.C.
• Eastside Medical Radiology PLLC
• Eastside Optometric, P.C.
• Eastside Orthotics & Prosthetics Inc
• Eastside Orthotics and Prosthetics, Inc.
• Eastside Physicians of Nyc, PLLC
• Eastside Physicians of Nyc, PLLC
• Eastside Podiatry Associates, PC

• Oral and Maxillofacial Surgery (Dentist) in New York, NY
• Providers in New York, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.