Individual provider Active NPI

Alan Leroy Winner, DDS

  • Dentist
  • New York, NY
National Provider Identifier
1922111285
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
NY36118 Issued in NY
Practice address
200 W 57TH St
Suite 1405
New York, NY 10019-3211
Phone
(212) 246-0573
Fax
(212) 246-9445
NPI assigned
Aug 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Dentist 122300000X NY36118 NY Primary

Addresses

Primary practice location

200 W 57TH St
Suite 1405
New York, NY 10019-3211

Mailing address

200 W 57TH St
Suite 1405
New York, NY 10019-3211
Phone (212) 246-0573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160614000689 NY Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 5991096422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NY36118NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922111285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 57TH ST",
            "address_2": "SUITE 1405",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193211",
            "telephone_number": "212-246-0573",
            "fax_number": "212-246-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 57TH ST",
            "address_2": "SUITE 1405",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193211",
            "telephone_number": "212-246-0573",
            "fax_number": "212-246-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINNER",
        "first_name": "ALAN",
        "middle_name": "LEROY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "NY36118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.