Individual provider Active NPI

Paul Ira Rosen, D.M.D.

  • General Practice Dentistry
  • Jamaica, NY
National Provider Identifier
1699765651
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
031862 Issued in NY
Practice address
8928 Merrick Blvd
100 Washington St. Hempstead Ny 11550
Jamaica, NY 11432-5243
Phone
(718) 291-9456
Fax
(718) 558-0861
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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 031862 NY Primary

Addresses

Primary practice location

8928 Merrick Blvd
100 Washington St. Hempstead Ny 11550
Jamaica, NY 11432-5243

Mailing address

35 Pheasant LN
Woodbury, NY 11797-1928
Phone (516) 364-9540

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
031862NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1699765651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 PHEASANT LN",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971928",
            "telephone_number": "516-364-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8928 MERRICK BLVD",
            "address_2": "100 WASHINGTON ST. HEMPSTEAD NY 11550",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325243",
            "telephone_number": "718-291-9456",
            "fax_number": "718-558-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "PAUL",
        "middle_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "031862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.