Robert J Licul, D.D.S.

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

044656 Issued in NY

Practice address

959 Brush Hollow Rd
Westbury, NY 11590-1778

Phone

(516) 333-5900

Fax

(516) 333-5868

NPI assigned

Nov 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Specialty

Oral Surgery

Education

State University of New York at Buffalo School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Long Island Oral Surgery AssociatesGroup PAC ID 4880584820, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Long Island Oral Surgery Associates

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Syosset, NY
  • NPI 1164614178

  NY

  Medicare reassignment Care Compare group
• Long Island Oral Surgery Associates

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Franklin Square, NY
  • NPI 1871785881
  NPD (past)
• Long Island Oral Surgery Associates, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Great Neck, NY
  • NPI 1306201066
  NPD (past)

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1700869765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 BRUSH HOLLOW RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901778",
            "telephone_number": "516-333-5900",
            "fax_number": "516-333-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 BRUSH HOLLOW RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901778",
            "telephone_number": "516-333-5900",
            "fax_number": "516-333-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICUL",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": "044656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02071410",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Lewis
• Li Orthodontics Nassau PC
• Brenda Liang, O.D.
• Marianne Pauline Libretto, L.M.H.C.
• Jody Meryl Lichtman Shankman
• Lidia Zacharski Nurse Practitioner in Family Health PC
• Andrelle Lightbourne
• Lighthouse Medical Rehabilitation P.C.
• Regine Pascale Lilavois, DPT
• Alyssa Krista Lim, RN

• All providers in Westbury, NY
• Oral and Maxillofacial Pathology Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.