Individual provider Active NPI

Eugene Martin Berman, D.D.S.

  • General Practice Dentistry
  • Jackson Heights, NY
National Provider Identifier
1962474312
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
026827 Issued in NY
Practice address
8801 35TH Ave
Side Door 88 St
Jackson Heights, NY 11372-5701
Phone
(718) 458-2292
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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 026827 NY Primary

Addresses

Primary practice location

8801 35TH Ave
Side Door 88 St
Jackson Heights, NY 11372-5701

Mailing address

8801 35TH Ave
Side Door 88 St
Jackson Heights, NY 11372-5701
Phone (718) 458-2292

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

LicenseStateTypeSpecialty
026827NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1962474312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8801 35TH AVE",
            "address_2": "SIDE DOOR 88 ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113725701",
            "telephone_number": "718-458-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8801 35TH AVE",
            "address_2": "SIDE DOOR 88 ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113725701",
            "telephone_number": "718-458-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "EUGENE",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "026827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.