Individual provider Active NPI

Roman Temkin, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Middletown, NY
National Provider Identifier
1720342959
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
059029 Issued in NY
Practice address
127 E Main St Ste 131
Middletown, NY 10940-5118
Phone
(845) 342-5866
NPI assigned
Jul 3, 2012
Last updated
Aug 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 059029 NY Primary

Addresses

Primary practice location

127 E Main St Ste 131
Middletown, NY 10940-5118

Mailing address

127 E Main St Ste 131
Middletown, NY 10940-5118
Phone (458) 342-5866

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
I20181107000350 NY Practitioner - Oral Surgery 5890049027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
059029NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Rego Park Dental P.C. Oral and Maxillofacial Surgery Current Accepting new patients
NPI 1871231050 CurrentSince May 29, 2022 Accepting new patients
Sage Dental of West Miami PLLC PastSince Jul 1, 2021 Accepting new patients

Locations

387 E Main St
Ste 101
Bay Shore, NY 11706
Phone (631) 665-1325

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1720342959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 E MAIN ST STE 131",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109405118",
            "telephone_number": "458-342-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 E MAIN ST STE 131",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109405118",
            "telephone_number": "845-342-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMKIN",
        "first_name": "ROMAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-03",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "059029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.