Individual provider Active NPI

Joseph Aaron Bruckner, D.D.S.

  • Dentist
  • Flushing, NY
National Provider Identifier
1861645913
Registry record updated Nov 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
053088 Issued in NY
Practice address
14119 70TH Ave
Flushing, NY 11367-1927
Phone
(347) 236-0043
NPI assigned
Nov 2, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 053088 NY Primary

Addresses

Primary practice location

14119 70TH Ave
Flushing, NY 11367-1927

Mailing address

14119 70TH Ave
Flushing, NY 11367-1927
Phone (347) 236-0043

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
053088NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1225584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225584000000",
    "number": "1861645913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14119 70TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671927",
            "telephone_number": "347-236-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14119 70TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671927",
            "telephone_number": "347-236-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKNER",
        "first_name": "JOSEPH",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-02",
        "last_updated": "2008-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "053088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2008; 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.