NPIMap

Organization Active NPI

Patrick J. Sabo, D.M.D. & Mark a. Rienecker, D.D.S., P.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Port Jefferson Station, NY
National Provider Identifier
1639231665
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
048812 Issued in NY
Legal business name
PATRICK J. SABO, D.M.D. & MARK A. RIENECKER, D.D.S., P.C.
Practice address
6 Medical Dr
Port Jefferson Station, NY 11776-1594
Phone
(631) 928-2655
Fax
(631) 399-1014
NPI assigned
Dec 15, 2006
Last updated
Dec 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Authorized official

Name
Patrick J. Sabo, D.M.D.NPI 1053474601
Title
President
Phone
(631) 399-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 048812 NY Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 046671 NY

Addresses

Primary practice location

6 Medical Dr
Port Jefferson Station, NY 11776-1594

Mailing address

6 Medical Dr
Port Jefferson Station, NY 11776-1594
Phone (631) 928-2655

Other identifiers 1

IdentifierTypeStateIssuer
03260964MedicaidNY

Other names 1

  • Robert J.Goldman, D.D.S., Elliot S.Taynor, D.D.S., P.C. Former legal business name

National Provider Directory

National Provider Directory

Locations

6 Medical Dr
Port Jefferson Station, NY 11776
Phone (631) 928-2655

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482883200000",
    "number": "1639231665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MEDICAL DR",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761594",
            "telephone_number": "631-928-2655",
            "fax_number": "631-399-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 MEDICAL DR",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761594",
            "telephone_number": "631-928-2655",
            "fax_number": "631-399-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK J. SABO, D.M.D. & MARK A. RIENECKER, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2016-12-28",
        "status": "A",
        "authorized_official_last_name": "SABO",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-399-1600",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "048812",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "046671",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03260964",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert J.Goldman, D.D.S., Elliot S.Taynor, D.D.S., P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; 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.