Individual provider Active NPI

Alexander Dorrough, DDS CAS

  • Dentist
  • Hawthorne, NY
National Provider Identifier
1821612201
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
062045 Issued in NY
Practice address
19 Skyline Dr
Hawthorne, NY 10532-2134
Phone
(914) 594-2700
NPI assigned
Jun 2, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 062045 NY Primary

Addresses

Primary practice location

19 Skyline Dr
Hawthorne, NY 10532-2134

Mailing address

33 Abbey LN Unit 3320
Danbury, CT 06810-5221
Phone (860) 985-1518

Other practice location 1

15 Mount Ebo Rd S
Brewster, NY 10509-4092
Phone (845) 278-6930

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
I20230601000417 NY Practitioner - Dentist 1355708660 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
062045NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Valley Regional Community Health Centers Inc CurrentSince May 12, 2023 Accepting new patients
Hudson Valley Regional Community Health Centers Inc CurrentSince May 12, 2023 Accepting new patients

Locations

15 Mount Ebo Rd S
Brewster, NY 10509
Phone (845) 278-6930

15 Mount Ebo Rd S
Ste 1
Brewster, NY 10509
Phone (845) 278-6930

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1821612201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 ABBEY LN UNIT 3320",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105221",
            "telephone_number": "860-985-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 SKYLINE DR",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322134",
            "telephone_number": "914-594-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Mount Ebo Rd S",
            "address_purpose": "LOCATION",
            "city": "Brewster",
            "state": "NY",
            "postal_code": "105094092",
            "country_code": "US",
            "telephone_number": "845-278-6930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORROUGH",
        "first_name": "ALEXANDER",
        "credential": "DDS CAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-02",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.