Active NPI
Brian Joseph Himelfarb
- Orthodontics and Dentofacial Orthopedics Dentistry
- Merrick, NY
National Provider Identifier
1902483563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 064063
- Practice address
- 2943 Clubhouse Rd
Merrick, NY 11566-4807 - Phone
- (516) 306-0159
- NPI assigned
- Mar 28, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 14182 | CT | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 064063 | NY | Primary |
Addresses
Primary practice location
2943 Clubhouse Rd
Merrick, NY 11566-4807
Mailing address
2943 Clubhouse Rd
Merrick, NY 11566-4807
Phone (516) 306-0159
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
| License | State | Type | Specialty |
|---|---|---|---|
| 064063 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 14182 | CT | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1902483563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2943 CLUBHOUSE RD",
"city": "MERRICK",
"state": "NY",
"postal_code": "115664807",
"telephone_number": "516-306-0159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2943 CLUBHOUSE RD",
"city": "MERRICK",
"state": "NY",
"postal_code": "115664807",
"telephone_number": "516-306-0159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIMELFARB",
"first_name": "BRIAN",
"middle_name": "JOSEPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-28",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CT",
"license": "14182",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "064063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merrick, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.