Sergey Yevgenyevich Basin, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02292100 Issued in NJ

Practice address

707 Elizabeth Ave
Elizabeth, NJ 07201-2806

Phone

(908) 354-1500

NPI assigned

Jan 31, 2007

Last updated

Mar 12, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

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

Practice roles

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

• B & K Family Dental, LLC

  • Dental Clinic/Center
  • Elizabeth, NJ
  • NPI 1083897375
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1578600326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 ELIZABETH AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012806",
            "telephone_number": "908-354-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 ELIZABETH AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012806",
            "telephone_number": "908-354-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASIN",
        "first_name": "SERGEY",
        "middle_name": "YEVGENYEVICH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052095",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02292100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150258",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02664973",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Savika Bansal
• Diane Barbosa
• Barnabas Health Medical Group PC
• Carlos Antonio Barragan, D.D.S.
• Kristie M Barthelemy, MA
• Ankita Bassi, MD
• Sanjay Batta, M.D
• Freddie Bautista
• Zlata G Bavli
• Jacqueline Baxley, MS, LPC, ACS

• General Practice Dentistry in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.