Individual provider Active NPI

Nora A Odingo, DMD

  • Oral and Maxillofacial Pathology Dentistry
  • Stony Brook, NY
National Provider Identifier
1922218023
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
050811-1 Issued in NY
Practice address
110 Sullivan HL
Stony Brook Dental Associates
Stony Brook, NY 11794-8705
Phone
(631) 632-8971
NPI assigned
May 23, 2007
Last updated
Jan 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 050811-1 NY Primary

Addresses

Primary practice location

110 Sullivan HL
Stony Brook Dental Associates
Stony Brook, NY 11794-8705

Mailing address

127 Westchester HL
Stony Brook University School of Dental Medicine
Stony Brook, NY 11794-8706
Phone (631) 632-8971

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
I20120503000007 NY Practitioner - Oral Surgery 4688836984 Practice locations: Stony Brook, NY

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Univ of Pennsylvania School of Dental Medicine, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

Sullivan HL
RM 170
Stony Brook, NY 11794-8705
Phone (631) 632-8971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
050811-1NYMDOral and Maxillofacial Pathology Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Dental Associates Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nora.odingo@direct.stonybrookmedicine.edu

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263859200000",
    "number": "1922218023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 WESTCHESTER HL",
            "address_2": "STONY BROOK UNIVERSITY SCHOOL OF DENTAL MEDICINE",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948706",
            "telephone_number": "631-632-8971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SULLIVAN HL",
            "address_2": "STONY BROOK DENTAL ASSOCIATES",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948705",
            "telephone_number": "631-632-8971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODINGO",
        "first_name": "NORA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2010-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": "050811-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.