Farra Isaacson, DDS PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

049280 Issued in NY

Legal business name

FARRA ISAACSON, DDS PLLC

Practice address

1150 Portion Rd
Suite 15
Holtsville, NY 11742-1074

Phone

(631) 696-3820

Fax

(631) 696-7780

NPI assigned

Mar 30, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Farra Isaacson, DDSNPI 1376515387

Title

Onwer/Dentist

Phone

(631) 696-3820

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Farra Marlene Isaacson, DDS

  • Dentist
  • Holtsville, NY
  • NPI 1376515387
  NPD Authorized official

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1891227682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 PORTION RD",
            "address_2": "SUITE 15",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117421074",
            "telephone_number": "631-696-3820",
            "fax_number": "631-696-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 PORTION RD",
            "address_2": "SUITE 15",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117421074",
            "telephone_number": "631-696-3820",
            "fax_number": "631-696-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARRA ISAACSON, DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "ISAACSON",
        "authorized_official_first_name": "FARRA",
        "authorized_official_title_or_position": "ONWER/DENTIST",
        "authorized_official_telephone_number": "631-696-3820",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "049280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02249296",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tammy Lauren Favaro, AGACNP
• Christine Felice, LPN
• Diana Feliciano
• Victor Feliciano

• Dentist in Holtsville, NY
• Providers in Holtsville, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.