MD Rezaul Islam Sarker, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

063081-01 Issued in NY

Practice address

890 E 2ND St
Jamestown, NY 14701-3824

Phone

(347) 459-6931

NPI assigned

Apr 5, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Inclusion Inc

  • Multi-Specialty Clinic/Center
  • Jamestown, NY
  • NPI 1699549287
  Medicare reassignment NPD

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

{
    "created_epoch": "1586044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1568091247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 E 2ND ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147013824",
            "telephone_number": "347-459-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 E 2ND ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147013824",
            "telephone_number": "347-459-6931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARKER",
        "first_name": "MD REZAUL ISLAM",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-05",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "063081-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Samuelson
• Mary Ann C Sanborn, MS, SPEC ED
• Amardeep Sapple, M.D.
• Saquib Ibrahim, Physician, PC
• Laura Sard, COTA
• Salim Sarvaiya, RPH
• Muhammad Ali Sarwar, M.D.
• Teresa Sasse, LMSW
• Satish K Mongia MD PC
• Carrie Saunders, RPH

• General Practice Dentistry in Jamestown, NY
• Providers in Jamestown, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.