NPIMap

Organization Active NPI

Raphaelson Dental Associates LLP

  • Dentist
  • Deer Park, NY
National Provider Identifier
1548338593
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
045415 Issued in NY
Legal business name
RAPHAELSON DENTAL ASSOCIATES LLP
Practice address
450 Grand Blvd
Deer Park, NY 11729-4286
Phone
(631) 667-4080
Fax
(631) 667-4261
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Authorized official

Name
Dr. Todd F Raphaelson, DDSNPI 1154590446
Title
Owner Dentist
Phone
(631) 667-4080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 045415 NY Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 050227 NY
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 047488 NY

Addresses

Primary practice location

450 Grand Blvd
Deer Park, NY 11729-4286

Mailing address

450 Grand Blvd
Deer Park, NY 11729-4286
Phone (631) 667-4080

National Provider Directory

National Provider Directory

Locations

450 Grand Blvd
Deer Park, NY 11729
Phone (631) 667-4080

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347580800000",
    "number": "1548338593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 GRAND BLVD",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117294286",
            "telephone_number": "631-667-4080",
            "fax_number": "631-667-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 GRAND BLVD",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117294286",
            "telephone_number": "631-667-4080",
            "fax_number": "631-667-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAPHAELSON DENTAL ASSOCIATES LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2012-09-14",
        "status": "A",
        "authorized_official_last_name": "RAPHAELSON",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "631-667-4080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "045415",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "050227",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "047488",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.