Active NPI
Stacey Tzakas
- General Practice Dentistry
- Bellmore, NY
National Provider Identifier
1871889022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 056 335-1
- Practice address
- 2085 Bellmore Ave
Bellmore, NY 11710-5603 - Phone
- (516) 826-3520
- Fax
- (516) 804-5591
- NPI assigned
- Jun 27, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 056 335-1 | NY | Primary |
Addresses
Primary practice location
2085 Bellmore Ave
Bellmore, NY 11710-5603
Mailing address
2085 Bellmore Ave
Bellmore, NY 11710-5603
Phone (516) 826-3520
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 14, 2016 through Mar 14, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056 335-1 | NY | MD | General Practice Dentistry |
| 056335 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406851200000",
"number": "1871889022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2085 BELLMORE AVE",
"city": "BELLMORE",
"state": "NY",
"postal_code": "117105603",
"telephone_number": "516-826-3520",
"fax_number": "516-804-5591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2085 BELLMORE AVE",
"city": "BELLMORE",
"state": "NY",
"postal_code": "117105603",
"telephone_number": "516-826-3520",
"fax_number": "516-804-5591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TZAKAS",
"first_name": "STACEY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-27",
"last_updated": "2014-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "056 335-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellmore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.