Individual provider Active NPI

James M Eisdorfer, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1699971812
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
030354 Issued in NY
Practice address
212 East 60 Street
Suite7C
New York, NY 10022
Phone
(212) 421-5445
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 030354 NY Primary

Addresses

Primary practice location

212 East 60 Street
Suite7C
New York, NY 10022

Mailing address

212 East 60 Street
Suite7C
New York, NY 10022
Phone (212) 421-5445

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160418001919 NY Order and Referring Only - DentistPractitioner - Dentist 9739487166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030354NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699971812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 EAST 60 STREET",
            "address_2": "SUITE7C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "212-421-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 EAST 60 STREET",
            "address_2": "SUITE7C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "212-421-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISDORFER",
        "first_name": "JAMES",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "030354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.