Individual provider Active NPI

Robert A Coleman, DMD

  • General Practice Dentistry
  • Merrick, NY
National Provider Identifier
1861534851
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30039 Issued in NY
Practice address
1955 Merrick Rd
Suite 101
Merrick, NY 11566-4642
Phone
(516) 378-0867
Fax
(516) 378-0067
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30039 NY Primary

Addresses

Primary practice location

1955 Merrick Rd
Suite 101
Merrick, NY 11566-4642

Mailing address

1955 Merrick Road
Suite101
Merrick, NY 11566
Phone (516) 378-0867

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
30039NYMDGeneral Practice Dentistry
030039NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861534851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 MERRICK ROAD",
            "address_2": "SUITE101",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "11566",
            "telephone_number": "516-378-0867",
            "fax_number": "516-378-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 MERRICK RD",
            "address_2": "SUITE 101",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664642",
            "telephone_number": "516-378-0867",
            "fax_number": "516-378-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "30039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.