Individual provider Active NPI

Tonya N. Bellamy-Bissoon, DDS

  • Dentist
  • Mineola, NY
National Provider Identifier
1932649274
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
060052 Issued in NY
Practice address
200 Old Country Rd Ste 460
Mineola, NY 11501-4293
Phone
(516) 663-1152
NPI assigned
Mar 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 060052 NY
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 060052 NY Primary

Addresses

Primary practice location

200 Old Country Rd Ste 460
Mineola, NY 11501-4293

Mailing address

200 Old Country Rd Ste 460
Mineola, NY 11501-4293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 12, 2023 through Jun 12, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
060052NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
400 Post Dental, PC General Practice CurrentSince Apr 16, 2023 Accepting new patients

Locations

400 Post Ave
Ste 103
Westbury, NY 11590
Phone (516) 515-1041

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1932649274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OLD COUNTRY RD STE 460",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OLD COUNTRY RD STE 460",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014293",
            "telephone_number": "516-663-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLAMY-BISSOON",
        "first_name": "TONYA",
        "middle_name": "N.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-06",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "060052",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "060052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.