Craig Michael Weitzman, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

057264 Issued in NY

Practice address

11203 Queens Blvd Ste 202
Forest Hills, NY 11375-5550

Phone

(718) 275-5700

NPI assigned

Jun 30, 2014

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Weitzman Oral Surgery and Implantology

  • Oral and Maxillofacial Surgery (Dentist)
  • Forest Hills, NY
  • NPI 1760762934
  NPD (past)

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1750796595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11203 QUEENS BLVD STE 202",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11203 QUEENS BLVD STE 202",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755550",
            "telephone_number": "718-275-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITZMAN",
        "first_name": "CRAIG",
        "middle_name": "MICHAEL",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "057264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Lee Weisman, MD
• Matthew Brian Weiss, D.C
• Stephan Allen Weitz, BC-HIS
• Weitzman Oral Surgery and Implantology
• Alexa Weitzman, L.AC.
• Howard C Weitzman, DDS
• Phyllis Weitzman, OTR/L
• Wellness Counseling PLC Inc
• Wellness Medical Care Supply LLC
• Wellness Psychotherapy Services Linda Bederman LCSW PLLC

• Oral and Maxillofacial Surgery (Dentist) in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.

Verify at the official NPI Registry.