Individual provider Active NPI

Levi Yechiel Grosser, D.M.D.

  • Pediatric Dentistry
  • Brooklyn, NY
National Provider Identifier
1598257339
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
060626 Issued in NY
Practice address
390 Berry St Ste B
Brooklyn, NY 11249-6086
Phone
(718) 218-7210
NPI assigned
Jun 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X 060626 NY Primary

Addresses

Primary practice location

390 Berry St Ste B
Brooklyn, NY 11249-6086

Mailing address

188 Donahue Ave
Inwood, NY 11096-1052
Phone (516) 398-4110

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

LicenseStateTypeSpecialty
060626NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan S. Waltner DDS PC Pediatric Dentistry CurrentSince Jul 24, 2022 Accepting new patients
Levi Y Grosser DMD PC Pediatric Dentistry CurrentSince Jun 23, 2025 Accepting new patients
Nathaniel Wieder, DMD, P.C. PastSince Jul 24, 2022 Accepting new patients

Locations

390 Berry St
Ste B
Brooklyn, NY 11249
Phone (718) 218-7200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1598257339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 DONAHUE AVE",
            "city": "INWOOD",
            "state": "NY",
            "postal_code": "110961052",
            "telephone_number": "516-398-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 BERRY ST STE B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112496086",
            "telephone_number": "718-218-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSER",
        "first_name": "LEVI",
        "middle_name": "YECHIEL",
        "name_prefix": "Mr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "060626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.