Individual provider Active NPI

Cristian Secareanu, D.D.S.

  • General Practice Dentistry
  • Woodside, NY
National Provider Identifier
1649484775
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
052507 Issued in NY
Practice address
5903 Roosevelt Ave
Woodside, NY 11377-3546
Phone
(718) 651-7700
NPI assigned
May 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X A052507-01 NY
General Practice Dentistry 1223G0001X 052507 NY Primary

Addresses

Primary practice location

5903 Roosevelt Ave
Woodside, NY 11377-3546

Mailing address

5903 Roosevelt Ave FL 2
Woodside, NY 11377-3546
Phone (718) 651-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A052507-01NYMDAcupuncturist
052507NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Csyies LLC General Practice CurrentSince Dec 24, 2023 Accepting new patients
C&O Dental,PLLC. PastSince Dec 24, 2023 Accepting new patients
Woodside Family Dental PLLC General Practice PastSince Dec 24, 2023 Accepting new patients

Locations

5903 Roosevelt Ave
Fl 2
Woodside, NY 11377
Phone (718) 651-7700

Organizations & group practices 3

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1649484775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5903 ROOSEVELT AVE FL 2",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773546",
            "telephone_number": "718-651-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5903 ROOSEVELT AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773546",
            "telephone_number": "718-651-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SECAREANU",
        "first_name": "CRISTIAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "A052507-01",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.