Individual provider Active NPI

Abraham Joseph Levy, DMD

  • General Practice Dentistry
  • Teaneck, NJ
National Provider Identifier
1710440425
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02800400 Issued in NJ
Practice address
780 Cedar LN
Teaneck, NJ 07666-1706
Phone
(201) 836-5333
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02800400 NJ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

780 Cedar LN
Teaneck, NJ 07666-1706

Mailing address

56 Campeau PL
Bergenfield, NJ 07621-3324
Phone (516) 659-7953

Other practice location 1

110 Bergen St
Newark, NJ 07103-2495
Phone (973) 972-4242

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
I20210118000316 NY Order and Referring Only - DentistPractitioner - Dentist 2961815766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02800400NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1710440425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 CAMPEAU PL",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076213324",
            "telephone_number": "516-659-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 CEDAR LN",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661706",
            "telephone_number": "201-836-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Bergen St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032495",
            "country_code": "US",
            "telephone_number": "973-972-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVY",
        "first_name": "ABRAHAM",
        "middle_name": "JOSEPH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02800400",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.