Individual provider Active NPI

Andrew Bryan Levy, DDS

  • Dentist
  • Forest Hills, NY
National Provider Identifier
1720335599
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
056210 Issued in NY
Practice address
11055 72ND Rd Ste L1
Forest Hills, NY 11375-5420
Phone
(516) 241-1068
NPI assigned
Aug 10, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 056210 NY Primary

Addresses

Primary practice location

11055 72ND Rd Ste L1
Forest Hills, NY 11375-5420

Mailing address

11055 72ND Rd Ste L1
Forest Hills, NY 11375-5420
Phone (516) 241-1068

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
I20151116000420 NY Order and Referring Only - DentistPractitioner - Dentist 0941510317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056210NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Village Dental P.C. CurrentSince Feb 16, 2020 Accepting new patients

Locations

11055 72nd Rd
Ste L1
Forest Hills, NY 11375
Phone (718) 268-1028

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1720335599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11055 72ND RD STE L1",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755420",
            "telephone_number": "516-241-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11055 72ND RD STE L1",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755420",
            "telephone_number": "516-241-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "ANDREW",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-10",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "056210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.