Individual provider Active NPI

Adam Felline

  • Pediatric Dentistry
  • Merrick, NY
National Provider Identifier
1720408990
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
058160 Issued in NY
Practice address
1987 Cynthia LN
Merrick, NY 11566-5111
Phone
(646) 270-5152
NPI assigned
Apr 25, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3902000000X NY
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 058160 NY Primary

Addresses

Primary practice location

1987 Cynthia LN
Merrick, NY 11566-5111

Mailing address

1987 Cynthia LN
Merrick, NY 11566-5111
Phone (646) 270-5152

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

LicenseStateTypeSpecialty
058160NYMDPediatric Dentist
3902000000XNYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adam Felline, DMD PLLC Pediatric Dentistry Current Accepting new patients
Adam Felline, DMD Pediatric Dentistry CurrentSince Jul 20, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1720408990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1987 CYNTHIA LN",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115665111",
            "telephone_number": "646-270-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1987 CYNTHIA LN",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115665111",
            "telephone_number": "646-270-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLINE",
        "first_name": "ADAM",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-25",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "3902000000X",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "058160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.