Individual provider Active NPI

Lloyd Gordon Soman, D.D.S.

  • Periodontics
  • New York, NY
National Provider Identifier
1609976216
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
037431 Issued in NY
Practice address
343 W 58TH St
Suite #8
New York, NY 10019-1108
Phone
(212) 757-1515
Fax
(212) 757-3286
NPI assigned
Sep 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 037431 NY Primary
Periodontics 1223P0300X 006450 CT

Addresses

Primary practice location

343 W 58TH St
Suite #8
New York, NY 10019-1108

Mailing address

343 W 58TH St
Suite #8
New York, NY 10019-1108
Phone (212) 757-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20150611000108 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1355662743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006450CTMDSpecialist
037431NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brooklyn Smile Dental Health Services Past Accepting new patients

Organizations & group practices 1

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": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609976216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 W 58TH ST",
            "address_2": "SUITE #8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191108",
            "telephone_number": "212-757-1515",
            "fax_number": "212-757-3286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 W 58TH ST",
            "address_2": "SUITE #8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191108",
            "telephone_number": "212-757-1515",
            "fax_number": "212-757-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMAN",
        "first_name": "LLOYD",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "037431",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "006450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.