Individual provider Active NPI

David Zelig, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Middletown, NY
National Provider Identifier
1699819854
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
004605 Issued in NY
Practice address
707 E Main St
Middletown, NY 10940-2650
Phone
(201) 500-7645
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 4605 TN
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DI02564100 NJ
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 004605 NY Primary

Addresses

Primary practice location

707 E Main St
Middletown, NY 10940-2650

Mailing address

420 Vomel Dr
New Milford, NJ 07646-2425
Phone (201) 500-7645

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180628000231 NY Practitioner - Maxillofacial SurgeryPractitioner - Oral SurgeryPractitioner - Dentist 2163778531 Practice locations: Middletown, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI02564100NJMDOral and Maxillofacial Surgery (Dentist)
4605TNMDOral and Maxillofacial Surgery (Dentist)
054777NYMDPharmacist
004605NYMDOral & Maxillofacial Surgery (D.M.D.)

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1699819854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 VOMEL DR",
            "city": "NEW MILFORD",
            "state": "NJ",
            "postal_code": "076462425",
            "telephone_number": "201-500-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "201-500-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELIG",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "4605",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "DI02564100",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "004605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.