Individual provider Active NPI

Jason David Rosenfeld, DDS

  • Pediatric Dentistry
  • Roslyn Heights, NY
National Provider Identifier
1821547746
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
060355 Issued in NY
Practice address
216 Willis Ave Ste 1
Roslyn Heights, NY 11577
Phone
(516) 625-3806
NPI assigned
Oct 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 060355 NY Primary

Addresses

Primary practice location

216 Willis Ave Ste 1
Roslyn Heights, NY 11577

Mailing address

87 Foxwood Dr
Jericho, NY 11753-1113

Other practice location 1

216 Willis Ave Ste 1
Roslyn Heights, NY 11577
Phone (516) 625-3806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
060355NYMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1821547746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 FOXWOOD DR",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 WILLIS AVE STE 1",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "11577",
            "telephone_number": "516-625-3806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 Willis Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Roslyn Heights",
            "state": "NY",
            "postal_code": "11577",
            "country_code": "US",
            "telephone_number": "516-625-3806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENFELD",
        "first_name": "JASON",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-04",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "060355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.