Individual provider Active NPI

Warren E Eng, DDS,FAGD,PLLC

  • General Practice Dentistry
  • Horseheads, NY
National Provider Identifier
1770645103
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
038842 Issued in NY
Practice address
2898 Westinghouse Rd
Suite 524
Horseheads, NY 14845-8196
Phone
(607) 739-3528
Fax
(607) 739-5371
NPI assigned
Dec 14, 2006
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
General Practice Dentistry 1223G0001X 038842 NY Primary

Addresses

Primary practice location

2898 Westinghouse Rd
Suite 524
Horseheads, NY 14845-8196

Mailing address

2898 Westinghouse Rd
Suite 524
Horseheads, NY 14845-8196
Phone (607) 739-3528

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
I20160524001164 NY Order and Referring Only - DentistPractitioner - Dentist 3678862083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038842NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770645103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2898 WESTINGHOUSE RD",
            "address_2": "SUITE 524",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148458196",
            "telephone_number": "607-739-3528",
            "fax_number": "607-739-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2898 WESTINGHOUSE RD",
            "address_2": "SUITE 524",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148458196",
            "telephone_number": "607-739-3528",
            "fax_number": "607-739-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENG",
        "first_name": "WARREN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS,FAGD,PLLC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "038842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Horseheads, NY

Sources for this page

Verify at the official NPI Registry.