Individual provider Active NPI

Leonard Sealy, D.D.S

  • General Practice Dentistry
  • Rockville Centre, NY
National Provider Identifier
1770614547
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
045936 Issued in NY
Practice address
2 Lincoln Ave
Suite#101
Rockville Centre, NY 11570-5775
Phone
(516) 596-9490
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 045936 NY Primary

Addresses

Primary practice location

2 Lincoln Ave
Suite#101
Rockville Centre, NY 11570-5775

Mailing address

2 Lincoln Ave
Suite#101
Rockville Centre, NY 11570-5775
Phone (516) 596-9490

Other identifiers 1

IdentifierTypeStateIssuer
113542770OtherNYTAX ID

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
I20150924002960 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7416265475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045936NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1770614547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LINCOLN AVE",
            "address_2": "SUITE#101",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705775",
            "telephone_number": "516-596-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LINCOLN AVE",
            "address_2": "SUITE#101",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705775",
            "telephone_number": "516-596-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEALY",
        "first_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "113542770",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.