Individual provider Active NPI

John A Dhaness Jr., CCC-SLP

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1457162901
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
034394 Issued in NY
Practice address
408 Jay St
Brooklyn, NY 11201-5173
Phone
(646) 939-6733
NPI assigned
Jan 15, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 034394 NY Primary

Addresses

Primary practice location

408 Jay St
Brooklyn, NY 11201-5173

Mailing address

12912 101St Ave
South Richmond Hill, NY 11419-1518
Phone (347) 337-2276

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
034394NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1457162901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12912 101ST AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191518",
            "telephone_number": "347-337-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 JAY ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015173",
            "telephone_number": "646-939-6733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHANESS",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "034394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.