Active NPI
Marshall Diamond, DMD
- Dentist
- Commack, NY
National Provider Identifier
1689894651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- NY029962
- Practice address
- 777 Larkfield Road
Commack, NY 11725 - Phone
- (631) 462-5780
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | NY029962 | NY | Primary |
Addresses
Primary practice location
777 Larkfield Road
Commack, NY 11725
Mailing address
10 Canterbury Road
Great Neck, NY 11021
Phone (516) 487-6039
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200228001949 | CT | Order and Referring Only - Dentist | 5991132110 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NY029962 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689894651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 CANTERBURY ROAD",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "11021",
"telephone_number": "516-487-6039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 LARKFIELD ROAD",
"city": "COMMACK",
"state": "NY",
"postal_code": "11725",
"telephone_number": "631-462-5780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAMOND",
"first_name": "MARSHALL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "NY029962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Commack, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.