NPIMap

Organization Active NPI

Joseph M. Licul, DDS, P.C.

  • Dental Clinic/Center
  • Southampton, NY
National Provider Identifier
1457867483
Registry record updated Dec 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
37608 Issued in NY
Legal business name
JOSEPH M. LICUL, DDS, P.C.
Practice address
8 N Main St
Southampton, NY 11968-3308
Phone
(631) 283-6591
NPI assigned
Dec 28, 2017
Last updated
Dec 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2017

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

Authorized official

Name
Dr. Joseph M Licul, DDS
Title
President
Phone
(917) 686-2712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 37608 NY Primary

Addresses

Primary practice location

8 N Main St
Southampton, NY 11968-3308

Mailing address

8 N Main St
Southampton, NY 11968-3308
Phone (631) 283-6591

National Provider Directory

National Provider Directory

Locations

8 N Main St
Southampton, NY 11968
Phone (631) 283-6591

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514419200000",
    "number": "1457867483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 N MAIN ST",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119683308",
            "telephone_number": "631-283-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 N MAIN ST",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119683308",
            "telephone_number": "631-283-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH M. LICUL, DDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-28",
        "last_updated": "2017-12-28",
        "status": "A",
        "authorized_official_last_name": "LICUL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-686-2712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "37608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2017; 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.