Nachum Augenbaum, D.D.S
Individual provider Active NPI General Practice Dentistry · Rocky Point, NY
NPI 1679708341 · NPPES record last updated Jul 21, 2024
Key facts
- NPI
- 1679708341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 0549751 (NY)
- Practice address
- 648 Route 25a
Rocky Point, NY 11778-8761 - Phone
- (631) 744-5700
- NPI assigned
- May 24, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150403000247 | NY | Order and Referring Only - Oral Surgery |
3971820861 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0549751 | NY | MD | General Practice Dentistry |
| 054975 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Long Island Dental Implant Associates | Current |
Accepting new patients |
Locations
648 Route 25A
Rocky Point, NY 11778
Phone (631) 744-5700
31 Fairway Dr
Rocky Point, NY 11778
Phone (631) 744-5700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0549751 | NY | Yes |
Addresses
Primary practice location
648 Route 25a
Rocky Point, NY 11778-8761
Mailing address
648 Route 25a
Rocky Point, NY 11778-8761
Phone (631) 744-5700
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All providers in Rocky Point, NY · General Practice Dentistry in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.