Active NPI
Jeffery Hom, DDS
- Dentist
- Brooklyn, NY
National Provider Identifier
1740293752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS50271
- Practice address
- 351 92ND St
2B
Brooklyn, NY 11209-6352 - Phone
- (415) 823-3093
- Fax
- (415) 823-3093
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DDS50271 | CA | Primary |
Addresses
Primary practice location
351 92ND St
2B
Brooklyn, NY 11209-6352
Mailing address
13-17 Elizabeth Street
Suite 510
New York, NY 10013
Phone (530) 246-5710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150804005030 | TX | Order and Referring Only - Other (Physician) | 0143534107 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS50271 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233273600000",
"number": "1740293752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13-17 ELIZABETH STREET",
"address_2": "SUITE 510",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10013",
"telephone_number": "530-246-5710",
"fax_number": "530-241-7838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "351 92ND ST",
"address_2": "2B",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112096352",
"telephone_number": "415-823-3093",
"fax_number": "415-823-3093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOM",
"first_name": "JEFFERY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2009-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS50271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.