Individual provider Active NPI

Christine Elise Valestrand, D.M.D.

  • Prosthodontics
  • East Setauket, NY
National Provider Identifier
1497873210
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
045294 Issued in NY
Practice address
100 S Jersey Ave
Suite 29
East Setauket, NY 11733-2034
Phone
(631) 689-5555
Fax
(631) 689-1503
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 045294 NY Primary

Addresses

Primary practice location

100 S Jersey Ave
Suite 29
East Setauket, NY 11733-2034

Mailing address

100 S Jersey Ave
Suite 29
East Setauket, NY 11733-2034
Phone (631) 689-5555

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
I20160302000601 NY Order and Referring Only - DentistPractitioner - Dentist 8527363415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045294NYMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497873210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S JERSEY AVE",
            "address_2": "SUITE 29",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332034",
            "telephone_number": "631-689-5555",
            "fax_number": "631-689-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JERSEY AVE",
            "address_2": "SUITE 29",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332034",
            "telephone_number": "631-689-5555",
            "fax_number": "631-689-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALESTRAND",
        "first_name": "CHRISTINE",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "045294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.