Active NPI
Charles A Lennon, DMD
- Prosthodontics
- New York, NY
National Provider Identifier
1609085869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 037444
- Practice address
- 635 Madison Ave
19TH Floor
New York, NY 10022-1009 - Phone
- (212) 752-1661
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 037444 | NY | Primary |
Addresses
Primary practice location
635 Madison Ave
19TH Floor
New York, NY 10022-1009
Mailing address
317 Upper Blvd
Ridgewood, NJ 07450-2422
Phone (201) 670-1822
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 |
|---|---|---|---|
| 037444 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609085869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 UPPER BLVD",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074502422",
"telephone_number": "201-670-1822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 MADISON AVE",
"address_2": "19TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100221009",
"telephone_number": "212-752-1661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LENNON",
"first_name": "CHARLES",
"middle_name": "A",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NY",
"license": "037444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.