Individual provider Active NPI

Sean D Jessamy, D.D.S

  • General Practice Dentistry
  • New Rochelle, NY
National Provider Identifier
1962551937
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
046031 Issued in NY
Practice address
119 Drake Ave
New Rochelle, NY 10805-1701
Phone
(914) 235-3670
Fax
(914) 235-3672
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X 046031 NY Primary

Addresses

Primary practice location

119 Drake Ave
New Rochelle, NY 10805-1701

Mailing address

119 Drake Ave
New Rochelle, NY 10805-1701
Phone (914) 235-3670

Other identifiers 1

IdentifierTypeStateIssuer
01588045MedicaidNY

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sean D Jessamy DDS PC General Practice Past Accepting new patients

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962551937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 DRAKE AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108051701",
            "telephone_number": "914-235-3670",
            "fax_number": "914-235-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 DRAKE AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108051701",
            "telephone_number": "914-235-3670",
            "fax_number": "914-235-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSAMY",
        "first_name": "SEAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01588045",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.