North Shore- Long Island Jewish Health System

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

052041 Issued in NY

Legal business name

NORTH SHORE- LONG ISLAND JEWISH HEALTH SYSTEM

Practice address

400 Community Dr
Manhasset, NY 11030-3815

Phone

(516) 562-4525

NPI assigned

Apr 27, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Sukrita Matta, DDS

Title

Dentist

Phone

(908) 410-1389

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272326400000",
    "number": "1871810119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303815",
            "telephone_number": "516-562-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE- LONG ISLAND JEWISH HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-27",
        "last_updated": "2010-04-27",
        "status": "A",
        "authorized_official_last_name": "MATTA",
        "authorized_official_first_name": "SUKRITA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "908-410-1389",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Shore University Hospital
• North Shore University Hospital
• North Shore University Hospital
• North Shore University Hospital
• North Shore- Long Island Jewish
• North Shore-Lij Health System
• North Shore-Lij Medical Group P.C.
• North-Shore Hospital
• Northshore Lij Health System
• Northwell Health Stern Family Center for Rehabilitation

• General Practice Dentistry in Manhasset, NY
• Providers in Manhasset, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2010; 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.