Individual provider Active NPI

Richard Eric Freedline, D.D.S.

  • Dentist
  • Great Neck, NY
National Provider Identifier
1629235635
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
040233 Issued in NY
Practice address
287 Northern Blvd
Suite 201
Great Neck, NY 11021-4717
Phone
(516) 482-6799
Fax
(516) 482-6811
NPI assigned
May 19, 2008
Last updated
May 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 040233 NY Primary

Addresses

Primary practice location

287 Northern Blvd
Suite 201
Great Neck, NY 11021-4717

Mailing address

287 Northern Blvd
Suite 201
Great Neck, NY 11021-4717
Phone (516) 482-6799

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
I20250227001560 NY Practitioner - Dentist 5698295160 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
White Hall Dental, PC Dentist CurrentSince Dec 16, 2024 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

27005 76th Ave
North New Hyde Pk, NY 11040

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1629235635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 NORTHERN BLVD",
            "address_2": "SUITE 201",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214717",
            "telephone_number": "516-482-6799",
            "fax_number": "516-482-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 NORTHERN BLVD",
            "address_2": "SUITE 201",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214717",
            "telephone_number": "516-482-6799",
            "fax_number": "516-482-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEDLINE",
        "first_name": "RICHARD",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "040233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.