Individual provider Active NPI

Jerold Levinbook, D.M.D.

  • General Practice Dentistry
  • Hicksville, NY
National Provider Identifier
1619006533
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
027027-1 Issued in NY
Practice address
71 N Broadway
Hicksville, NY 11801-2903
Phone
(516) 822-6555
NPI assigned
Mar 5, 2007
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 027027-1 NY Primary

Addresses

Primary practice location

71 N Broadway
Hicksville, NY 11801-2903

Mailing address

71 N Broadway
Hicksville, NY 11801-2903
Phone (516) 822-6555

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
I20160315001821 NY Order and Referring Only - DentistPractitioner - Dentist 3971809088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
027027-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619006533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 N BROADWAY",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118012903",
            "telephone_number": "516-822-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 N BROADWAY",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118012903",
            "telephone_number": "516-822-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINBOOK",
        "first_name": "JEROLD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "027027-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

Verify at the official NPI Registry.