Individual provider Active NPI

Ronald Wender, DDS

  • General Practice Dentistry
  • Stony Brook, NY
National Provider Identifier
1891895918
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0284091 Issued in NY
Practice address
2500 Nesconset Hwy
Stony Brook Medical Park Suite 11a
Stony Brook, NY 11790
Phone
(631) 751-7171
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

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 0284091 NY Primary

Addresses

Primary practice location

2500 Nesconset Hwy
Stony Brook Medical Park Suite 11a
Stony Brook, NY 11790

Mailing address

44 Joel Place
Oceanside, NY 11572
Phone (516) 678-5688

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
0284091NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891895918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 JOEL PLACE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "11572",
            "telephone_number": "516-678-5688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY",
            "address_2": "STONY BROOK MEDICAL PARK SUITE 11A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11790",
            "telephone_number": "631-751-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDER",
        "first_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0284091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.