Bruce Arthur Merriam, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

028780-1 Issued in NY

Practice address

250 Patchogue Yaphank Rd
Suite 9
East Patchogue, NY 11772-4800

Phone

(631) 475-3400

Fax

(631) 475-3465

NPI assigned

Dec 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Christopher Joubert DDS PC

  • Dental Clinic/Center
  • East Patchogue, NY
  • NPI 1902206725
  NPD (past)

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1619150802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PATCHOGUE YAPHANK RD",
            "address_2": "SUITE 9",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724800",
            "telephone_number": "631-475-3400",
            "fax_number": "631-475-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PATCHOGUE YAPHANK RD",
            "address_2": "SUITE 9",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724800",
            "telephone_number": "631-475-3400",
            "fax_number": "631-475-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRIAM",
        "first_name": "BRUCE",
        "middle_name": "ARTHUR",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "028780-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endodontics in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Endodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.

Verify at the official NPI Registry.