Jalal Ud-Din Bukhari

Primary specialty

Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X

License

060812 Issued in NY

Practice address

53 Betty Ann Dr
South Setauket, NY 11720-1043

Phone

(631) 355-9371

NPI assigned

Apr 28, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1720513625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 BALSAM DR",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118012051",
            "telephone_number": "631-355-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 BETTY ANN DR",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "117201043",
            "telephone_number": "631-355-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKHARI",
        "first_name": "JALAL",
        "middle_name": "UD-DIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-28",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "NY",
            "license": "060812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "97664419F45226",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen A Bowen-Sklar, PMHNP-BC
• Harshbhari Shadasharan Brahmbhatt
• Nicole Denise Bren, MA CCC SLP
• Marguerita Brugmann, LMSW
• Rosemarie Bruno, LCSW
• Filomena Buncke, PHD, NP
• Kimberly A Buncke, NP
• Kara Lynn Byrne, M.S., SLP
• Phyllis Calabrese, LCSW
• Joseph Catalano

• Dentist in South Setauket, NY
• Providers in South Setauket, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.