Active NPI
Brian Keith Tanz, DDS
- Prosthodontics
- New York, NY
National Provider Identifier
1780893081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 041114
- Practice address
- 210 E 68TH St
Suite 1-E
New York, NY 10021-6047 - Phone
- (212) 879-2277
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 041114 | NY | Primary |
Addresses
Primary practice location
210 E 68TH St
Suite 1-E
New York, NY 10021-6047
Mailing address
Pob 16531769
Sioux Falls, SD 57186
Phone (212) 879-2277
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 24, 2015 through Dec 24, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041114 | NY | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780893081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "POB 16531769",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "57186",
"telephone_number": "212-879-2277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 E 68TH ST",
"address_2": "SUITE 1-E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100216047",
"telephone_number": "212-879-2277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANZ",
"first_name": "BRIAN",
"middle_name": "KEITH",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NY",
"license": "041114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.