Active NPI
Wilfred Cheng, DMD
- Periodontics
- Great Neck, NY
National Provider Identifier
1477915965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 062268-01
- Practice address
- 233 E Shore Rd Ste 104
Great Neck, NY 11023-2433 - Phone
- (516) 466-1070
- NPI assigned
- Mar 23, 2016
- Reactivated
- Nov 16, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 062268-01 | NY | Primary |
Addresses
Primary practice location
233 E Shore Rd Ste 104
Great Neck, NY 11023-2433
Mailing address
233 E Shore Rd Ste 104
Great Neck, NY 11023-2433
Phone (516) 466-1070
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
| License | State | Type | Specialty |
|---|---|---|---|
| 062268-01 | NY | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692144000000",
"number": "1477915965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "233 E SHORE RD STE 104",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110232433",
"telephone_number": "516-466-1070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 E SHORE RD STE 104",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110232433",
"telephone_number": "516-466-1070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHENG",
"first_name": "WILFRED",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-23",
"last_updated": "2023-08-16",
"certification_date": "2023-08-16",
"deactivation_date": "2016-10-31",
"reactivation_date": "2016-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NY",
"license": "062268-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.