NPIMap

Organization Active NPI

Robert Teisch & Joseph a Simonetti and Robert Domozych DDS PC

  • Dental Clinic/Center
  • East Islip, NY
National Provider Identifier
1821008160
Registry record updated May 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
50030265 Issued in NY
Legal business name
ROBERT TEISCH & JOSEPH A SIMONETTI AND ROBERT DOMOZYCH DDS PC
Practice address
127 W Main St
East Islip, NY 11730-2343
Phone
(631) 277-4848
Fax
(631) 277-4849
NPI assigned
Aug 9, 2006
Last updated
May 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2015

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

Authorized official

Name
Dr. Scott Simonetti, DDSNPI 1356480768
Title
Dentist Partner
Phone
(631) 234-7979

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 50030265 NY Primary

Addresses

Primary practice location

127 W Main St
East Islip, NY 11730-2343

Mailing address

127 W Main St
East Islip, NY 11730-2343
Phone (631) 277-4848

Other identifiers 1

IdentifierTypeStateIssuer
01435423MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430438400000",
    "number": "1821008160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W MAIN ST",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302343",
            "telephone_number": "631-277-4848",
            "fax_number": "631-277-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 W MAIN ST",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302343",
            "telephone_number": "631-277-4848",
            "fax_number": "631-277-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT TEISCH & JOSEPH A SIMONETTI AND ROBERT DOMOZYCH DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2015-05-01",
        "status": "A",
        "authorized_official_last_name": "SIMONETTI",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "DENTIST PARTNER",
        "authorized_official_telephone_number": "631-234-7979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "50030265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01435423",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.