Individual provider Active NPI

Eve Libby Belecen, D.D.S.

  • Dentist
  • Forest Hills, NY
National Provider Identifier
1487064911
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
057905-1 Issued in NY
Practice address
10225 67TH Dr
Apt 5R
Forest Hills, NY 11375-2860
Phone
(516) 729-1448
NPI assigned
May 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 057905-1 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

10225 67TH Dr
Apt 5R
Forest Hills, NY 11375-2860

Mailing address

10225 67TH Dr
Apt 5R
Forest Hills, NY 11375-2860
Phone (516) 729-1448

Other identifiers 1

IdentifierTypeStateIssuer
04224719MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160301001848 NY Order and Referring Only - DentistPractitioner - Dentist 7517262447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
057905-1NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1487064911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10225 67TH DR",
            "address_2": "APT 5R",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752860",
            "telephone_number": "516-729-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10225 67TH DR",
            "address_2": "APT 5R",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752860",
            "telephone_number": "516-729-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELECEN",
        "first_name": "EVE",
        "middle_name": "LIBBY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-06",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057905-1",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04224719",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.