Robert Maxwell Trager, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

026753 Issued in NY

Practice address

111-02 Farmers Blvd
Hollis, NY 11412

Phone

(718) 454-3442

Fax

(718) 454-3888

NPI assigned

Nov 4, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1699766899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S SERVICE ROAD",
            "address_2": "JFK INT'L AIRPORT",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11430",
            "telephone_number": "718-656-4747",
            "fax_number": "718-656-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111-02 FARMERS BLVD",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "11412",
            "telephone_number": "718-454-3442",
            "fax_number": "718-454-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAGER",
        "first_name": "ROBERT",
        "middle_name": "MAXWELL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "026753",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "10531",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00289845",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Basmattie Uditsukhu
• Caroline Amenaghawon Ugbogbo, NP
• Tatiana Uguru, PMHNP
• Udodirim Joy Ukwu, LCSW

• Dentist in Hollis, NY
• Providers in Hollis, NY by specialty
• Dentist in New York

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

Verify at the official NPI Registry.