Individual provider Active NPI

Justin Isaac Fox, D.D.S.

  • Dentist
  • Albany, NY
National Provider Identifier
1841676087
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
058478 Issued in NY
Practice address
822 New Scotland Ave
Albany, NY 12208-1261
Phone
(518) 482-6936
NPI assigned
Aug 10, 2015
Last updated
Mar 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 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 058478 NY Primary

Addresses

Primary practice location

822 New Scotland Ave
Albany, NY 12208-1261

Mailing address

1873 Western Ave
#200
Albany, NY 12203-5028
Phone (518) 869-1044

Other practice location 1

264 Osborne Rd
Albany, NY 12211-1878
Phone (518) 434-3151

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
I20161213000304 NY Order and Referring Only - DentistPractitioner - Dentist 2860772688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
058478NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael J Lipnick DMD and Vincent Giglio DDS PLLC PastSince Mar 31, 2024 Accepting new patients
Emblemhealth Medical and Dental Services Inc. Past Accepting new patients
Norman J. Levine DDS & Michael J. Lipnick DMD, PC PastSince Mar 31, 2024 Accepting new patients
Group Health Incorporated Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1841676087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1873 WESTERN AVE",
            "address_2": "#200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122035028",
            "telephone_number": "518-869-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081261",
            "telephone_number": "518-482-6936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "264 Osborne Rd",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122111878",
            "country_code": "US",
            "telephone_number": "518-434-3151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOX",
        "first_name": "JUSTIN",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-10",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "058478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.