Individual provider Active NPI

Bruce Douglas Parham, D.D.S

  • Dentist
  • New Rochelle, NY
National Provider Identifier
1659501336
Registry record updated Jul 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
040314 Issued in NY
Practice address
29 The Blvd
New Rochelle, NY 10801-2814
Phone
(914) 235-4485
Fax
(718) 579-8352
NPI assigned
Jul 16, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 040314 NY Primary

Addresses

Primary practice location

29 The Blvd
New Rochelle, NY 10801-2814

Mailing address

29 The Blvd
New Rochelle, NY 10801-2814
Phone (914) 235-4485

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

NPI Registry JSON

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247788800000",
    "number": "1659501336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 THE BLVD",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108012814",
            "telephone_number": "914-235-4485",
            "fax_number": "718-579-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 THE BLVD",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108012814",
            "telephone_number": "914-235-4485",
            "fax_number": "718-579-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARHAM",
        "first_name": "BRUCE",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-16",
        "last_updated": "2009-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "040314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2009; 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.