Individual provider Active NPI

Stuart Teper, DDS

  • General Practice Dentistry
  • Plainview, NY
National Provider Identifier
1457550212
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38636 Issued in NY
Practice address
25 Wayne Drive
Plainview, NY 11803-4917
Phone
(516) 822-2158
Fax
(516) 822-2158
NPI assigned
Jul 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 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 38636 NY Primary

Addresses

Primary practice location

25 Wayne Drive
Plainview, NY 11803-4917

Mailing address

25 Wayne Drive
Plainview, NY 11803-4917
Phone (516) 822-2158

Other identifiers 1

IdentifierTypeStateIssuer
02 496 239MedicaidNY

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
38636NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1457550212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WAYNE DRIVE",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034917",
            "telephone_number": "516-822-2158",
            "fax_number": "516-822-2158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WAYNE DRIVE",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034917",
            "telephone_number": "516-822-2158",
            "fax_number": "516-822-2158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEPER",
        "first_name": "STUART",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "38636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02 496 239",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.