Individual provider Active NPI

Mordechai Eisenberger

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1871651489
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
049686 Issued in NY
Practice address
8707 Flatlands Ave
Brooklyn, NY 11236-3609
Phone
(718) 257-7777
NPI assigned
Dec 5, 2006
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 049686 NY Primary

Addresses

Primary practice location

8707 Flatlands Ave
Brooklyn, NY 11236-3609

Mailing address

8707 Flatlands Ave
Brooklyn, NY 11236-3609
Phone (718) 257-7777

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
I20160330000378 NY Order and Referring Only - DentistPractitioner - Dentist 2163729526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049686NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871651489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8707 FLATLANDS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363609",
            "telephone_number": "718-257-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8707 FLATLANDS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363609",
            "telephone_number": "718-257-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERGER",
        "first_name": "MORDECHAI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.