Individual provider Active NPI

Dustin R Solis, DDS

  • Dentist
  • East Rockaway, NY
National Provider Identifier
1730382367
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
053183 Issued in NY
Practice address
82 Judith CT
East Rockaway, NY 11518-1630
Phone
(516) 593-2720
Fax
(516) 593-5048
NPI assigned
Jun 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 053183 NY Primary

Addresses

Primary practice location

82 Judith CT
East Rockaway, NY 11518-1630

Mailing address

268 Roosevelt Ave
Freeport, NY 11520-5412
Phone (516) 868-2680

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
053183NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1181433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730382367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 ROOSEVELT AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115205412",
            "telephone_number": "516-868-2680",
            "fax_number": "516-868-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 JUDITH CT",
            "city": "EAST ROCKAWAY",
            "state": "NY",
            "postal_code": "115181630",
            "telephone_number": "516-593-2720",
            "fax_number": "516-593-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIS",
        "first_name": "DUSTIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "053183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.