Individual provider Active NPI

Jason Fisher, DDS

  • Dentist
  • Levittown, NY
National Provider Identifier
1699166165
Registry record updated Apr 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
058657-1 Issued in NY
Practice address
2920 Hempstead Tpke Ste 2
Levittown, NY 11756-1402
Phone
(516) 796-8300
NPI assigned
Feb 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 058657-1 NY Primary

Addresses

Primary practice location

2920 Hempstead Tpke Ste 2
Levittown, NY 11756-1402

Mailing address

1925 Eastchester Rd Apt 25H
Bronx, NY 10461-2107
Phone (215) 290-5670

Other practice location 1

362 W 52nd St
Apt 12
New York, NY 10019-6215
Phone (215) 290-5670

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
058657-1NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cassis and Morcos Dental Services Dentist Past 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": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523664000000",
    "number": "1699166165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 EASTCHESTER RD APT 25H",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612107",
            "telephone_number": "215-290-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 HEMPSTEAD TPKE STE 2",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117561402",
            "telephone_number": "516-796-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "362 W 52nd St",
            "address_2": "Apt 12",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100196215",
            "country_code": "US",
            "telephone_number": "215-290-5670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISHER",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-05",
        "last_updated": "2018-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "058657-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2018; 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.