Individual provider Active NPI

Sam Morhaim, D.D.S.

  • Periodontics
  • Bayside, NY
National Provider Identifier
1760606248
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
044652 Issued in NY
Practice address
2391 Bell Blvd
Bayside Dental Associates
Bayside, NY 11360-2019
Phone
(718) 631-7337
Fax
(718) 428-0431
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
No

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
Periodontics 1223P0300X 044652 NY Primary

Addresses

Primary practice location

2391 Bell Blvd
Bayside Dental Associates
Bayside, NY 11360-2019

Mailing address

2391 Bell Blvd
Bayside Dental Associates
Bayside, NY 11360-2019
Phone (718) 631-7337

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190122003178 NY Order and Referring Only - DentistPractitioner - Dentist 9133466659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
044652NYMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760606248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2391 BELL BLVD",
            "address_2": "BAYSIDE DENTAL ASSOCIATES",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602019",
            "telephone_number": "718-631-7337",
            "fax_number": "718-428-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2391 BELL BLVD",
            "address_2": "BAYSIDE DENTAL ASSOCIATES",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602019",
            "telephone_number": "718-631-7337",
            "fax_number": "718-428-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORHAIM",
        "first_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "044652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.