Individual provider Active NPI

Jeffrey Bleicher, D.D.S.

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1902896152
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
031292 Issued in NY
Practice address
1532 Flatbush Ave
Brooklyn, NY 11210-2427
Phone
(718) 434-5800
Fax
(718) 434-8260
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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 031292 NY Primary

Addresses

Primary practice location

1532 Flatbush Ave
Brooklyn, NY 11210-2427

Mailing address

432 Buchanan Ave
Staten Island, NY 10314-4103

Other identifiers 1

IdentifierTypeStateIssuer
00305739MedicaidNY

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1902896152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 BUCHANAN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144103",
            "fax_number": "718-434-8260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 FLATBUSH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112102427",
            "telephone_number": "718-434-5800",
            "fax_number": "718-434-8260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEICHER",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "031292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00305739",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.