Individual provider Active NPI

John W Siegal, D.D.S.

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1689902470
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
036656 Issued in NY
Practice address
49 West 12TH St
Suite 1C
New York, NY 10011-8530
Phone
(212) 627-2929
Fax
(212) 627-0323
NPI assigned
Dec 7, 2009
Last updated
Dec 7, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 036656 NY Primary

Addresses

Primary practice location

49 West 12TH St
Suite 1C
New York, NY 10011-8530

Mailing address

49 West 12TH St
Suite 1C
New York, NY 10011-8530
Phone (212) 627-2929

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
036656NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1689902470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 WEST 12TH ST",
            "address_2": "SUITE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118530",
            "telephone_number": "212-627-2929",
            "fax_number": "212-627-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 WEST 12TH ST",
            "address_2": "SUITE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118530",
            "telephone_number": "212-627-2929",
            "fax_number": "212-627-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGAL",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-07",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "036656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.