Active NPI
Alexander Royzenblat
- Endodontics
- Norfolk, VA
National Provider Identifier
1588635072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 6495-15
- Practice address
- 1721 Admiral Taussig Blvd
Sewell'S Point Branch Medical Clinic
Norfolk, VA 23511-2802 - Phone
- (760) 613-3917
- NPI assigned
- Feb 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4278 | SC | |
| General Practice Dentistry | 1223G0001X | 2901018211 | MI | |
| Endodontics | 1223E0200X | 6495-15 | WI | Primary |
| Dentist | 122300000X | 019028225 | IL | |
| Dentist | 122300000X | 49796 | CA | |
| Endodontics | 1223E0200X | 0401414365 | VA |
Addresses
Primary practice location
1721 Admiral Taussig Blvd
Sewell'S Point Branch Medical Clinic
Norfolk, VA 23511-2802
Mailing address
903 Henphil Farms CT
Chesapeake, VA 23320-8199
Phone (760) 613-3917
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49796 | CA | MD | Dentist |
| 019028225 | IL | MD | Dentist |
| 0401414365 | VA | MD | Endodontist |
| 6495-15 | WI | MD | Endodontist |
| 2901018211 | MI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413590400000",
"number": "1588635072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "903 HENPHIL FARMS CT",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233208199",
"telephone_number": "760-613-3917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1721 ADMIRAL TAUSSIG BLVD",
"address_2": "SEWELL'S POINT BRANCH MEDICAL CLINIC",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235112802",
"telephone_number": "760-613-3917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROYZENBLAT",
"first_name": "ALEXANDER",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-01",
"last_updated": "2014-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "4278",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901018211",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "WI",
"license": "6495-15",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019028225",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "49796",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "VA",
"license": "0401414365",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.