Greenbaum & Kobren D.D.S, P.L.L.C

Primary specialty

DentistTaxonomy code 122300000X

License

048262 Issued in NY

Legal business name

GREENBAUM & KOBREN D.D.S, P.L.L.C

Practice address

14 Maple St
Suite 101
Port Washington, NY 11050-2967

Phone

(516) 767-2484

Fax

(516) 767-1672

NPI assigned

Sep 22, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Michael Greenbaum, D.D.S

Title

Dentist

Phone

(516) 767-2484

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MIchael Greenbaum D.D.S Doing business as

Locations

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316649600000",
    "number": "1487937793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MAPLE ST",
            "address_2": "SUITE 101",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110502967",
            "telephone_number": "516-767-2484",
            "fax_number": "516-767-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MAPLE ST",
            "address_2": "SUITE 101",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110502967",
            "telephone_number": "516-767-2484",
            "fax_number": "516-767-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBAUM & KOBREN D.D.S, P.L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A",
        "authorized_official_last_name": "GREENBAUM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "516-767-2484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "048262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "2068460",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIchael Greenbaum D.D.S",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Port Washington, NY
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• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.