Individual provider Active NPI

Mark Schlesinger, DDS

  • Periodontics
  • New York, NY
National Provider Identifier
1669479408
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
050064 Issued in NY
Practice address
30 E 60TH St Ste 703
New York, NY 10022-1076
Phone
(212) 213-9333
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 050064 NY Primary

Addresses

Primary practice location

30 E 60TH St Ste 703
New York, NY 10022-1076

Mailing address

1995 Lake End Rd
Merrick, NY 11566
Phone (917) 292-8623

Other practice location 1

2780 Merrick Rd
Bellmore, NY 11710-5720
Phone (516) 308-7646

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
I20151223001570 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6901107549

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
050064NYMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Greg R. Diamond D.D.S., P.C. Periodontics PastSince Apr 14, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669479408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 LAKE END RD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "11566",
            "telephone_number": "917-292-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 60TH ST STE 703",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221076",
            "telephone_number": "212-213-9333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2780 Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Bellmore",
            "state": "NY",
            "postal_code": "117105720",
            "country_code": "US",
            "telephone_number": "516-308-7646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHLESINGER",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "050064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.