Individual provider Active NPI

Nicholas Christopher Navarro, DDS

  • Dentist
  • Bay Shore, NY
National Provider Identifier
1770882953
Registry record updated Mar 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
039612 Issued in NY
Practice address
387 E Main St
Suite 105
Bay Shore, NY 11706-8413
Phone
(631) 665-3422
Fax
(631) 859-1713
NPI assigned
Mar 27, 2011
Last updated
Mar 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 039612 NY Primary

Addresses

Primary practice location

387 E Main St
Suite 105
Bay Shore, NY 11706-8413

Mailing address

387 E Main St
Suite 105
Bay Shore, NY 11706-8413
Phone (631) 665-3422

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
I20150507000776 NY Order and Referring Only - DentistPractitioner - Dentist 1951620277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1301184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301184000000",
    "number": "1770882953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 E MAIN ST",
            "address_2": "SUITE 105",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068413",
            "telephone_number": "631-665-3422",
            "fax_number": "631-859-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 E MAIN ST",
            "address_2": "SUITE 105",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068413",
            "telephone_number": "631-665-3422",
            "fax_number": "631-859-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVARRO",
        "first_name": "NICHOLAS",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-27",
        "last_updated": "2011-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "039612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.