Active NPI
John Dennis Dyer, DDS
- General Practice Dentistry
- Bronx, NY
National Provider Identifier
1710066691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 051657
- Practice address
- 111 E 210TH St
Dental Department
Bronx, NY 10467-2401 - Phone
- (718) 920-4984
- Fax
- (718) 515-5419
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 051657 | NY | Primary |
Addresses
Primary practice location
111 E 210TH St
Dental Department
Bronx, NY 10467-2401
Mailing address
55 W End Ave
Apt. #S2J
New York, NY 10023-7842
Phone (718) 866-7452
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051657 | NY | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710066691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 W END AVE",
"address_2": "APT. #S2J",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100237842",
"telephone_number": "718-866-7452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E 210TH ST",
"address_2": "DENTAL DEPARTMENT",
"city": "BRONX",
"state": "NY",
"postal_code": "104672401",
"telephone_number": "718-920-4984",
"fax_number": "718-515-5419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYER",
"first_name": "JOHN",
"middle_name": "DENNIS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "051657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.