NPIMap

Organization Active NPI

Suffolk Endodontics

  • Endodontics
  • Patchogue, NY
National Provider Identifier
1609077494
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
047118 Issued in NY
Legal business name
SUFFOLK ENDODONTICS
Practice address
70 Medford Ave
Patchogue, NY 11772-1202
Phone
(631) 447-6060
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jack H Casale
Title
Owner
Phone
(631) 447-6060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 047118 NY Primary

Addresses

Primary practice location

70 Medford Ave
Patchogue, NY 11772-1202

Mailing address

70 Medford Ave
Patchogue, NY 11772-1202
Phone (631) 447-6060

National Provider Directory

National Provider Directory

Locations

70 Medford Ave
Patchogue, NY 11772
Phone (631) 447-6060

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609077494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 MEDFORD AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721202",
            "telephone_number": "631-447-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MEDFORD AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721202",
            "telephone_number": "631-447-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUFFOLK ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CASALE",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-447-6060",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "047118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.