Individual provider Active NPI

Chelsea Fosse, DMD

  • Dentist
  • Bronx, NY
National Provider Identifier
1982107405
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02699100 Issued in NJ
Practice address
1400 Pelham Pkwy S
Bronx, NY 10461
Phone
(718) 918-3419
NPI assigned
Mar 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 060136 NY
Dentist 122300000X 22DI02699100 NJ Primary

Addresses

Primary practice location

1400 Pelham Pkwy S
Bronx, NY 10461

Mailing address

384 Essex Ave
Bloomfield, NJ 07003-2813
Phone (231) 740-6023

Other practice location 1

533 Monroe St Apt 1B
Hoboken, NJ 07030-1765
Phone (231) 740-6023

Other practice location 2

384 Essex Ave
Bloomfield, NJ 07003-2813
Phone (231) 740-6023

Other practice location 3

17 S Warren St
Dover, NJ 07801-4506
Phone (973) 328-3344

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
22DI02699100NJMDDentist
060136NYMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1520726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1982107405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 ESSEX AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032813",
            "telephone_number": "231-740-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "718-918-3419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "533 Monroe St Apt 1B",
            "address_purpose": "LOCATION",
            "city": "Hoboken",
            "state": "NJ",
            "postal_code": "070301765",
            "country_code": "US",
            "telephone_number": "231-740-6023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "384 Essex Ave",
            "address_purpose": "LOCATION",
            "city": "Bloomfield",
            "state": "NJ",
            "postal_code": "070032813",
            "country_code": "US",
            "telephone_number": "231-740-6023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17 S Warren St",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "NJ",
            "postal_code": "078014506",
            "country_code": "US",
            "telephone_number": "973-328-3344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOSSE",
        "first_name": "CHELSEA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-11",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "060136",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02699100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.