Individual provider Active NPI

Nathaniel Sasson, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1720167109
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
036117 Issued in NY
Practice address
370 9TH St
Brooklyn, NY 11215-8131
Phone
(718) 965-9823
Fax
(718) 499-5700
NPI assigned
Nov 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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 036117 NY Primary

Addresses

Primary practice location

370 9TH St
Brooklyn, NY 11215-8131

Mailing address

370 9TH St
Brooklyn, NY 11215-8131
Phone (718) 965-9823

Other identifiers 1

IdentifierTypeStateIssuer
00646346MedicaidNY

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
I20150512000445 NY Order and Referring Only - DentistPractitioner - Dentist 9234458357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036117NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1162598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1720167109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 9TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112158131",
            "telephone_number": "718-965-9823",
            "fax_number": "718-499-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 9TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112158131",
            "telephone_number": "718-965-9823",
            "fax_number": "718-499-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASSON",
        "first_name": "NATHANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-04",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "036117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00646346",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.