Individual provider Active NPI

Allan Katz, DDS

  • General Practice Dentistry
  • Pomona, NY
National Provider Identifier
1992788103
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31155 Issued in NY
Practice address
40 Old Route 202a
Pomona, NY 10970-2848
Phone
(845) 354-6619
Fax
(845) 354-1893
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 31155 NY Primary
General Practice Dentistry 1223G0001X 11450 NJ
General Practice Dentistry 1223G0001X 8358 GA
General Practice Dentistry 1223G0001X 5814 MD
General Practice Dentistry 1223G0001X 4655 VA

Addresses

Primary practice location

40 Old Route 202a
Pomona, NY 10970-2848

Mailing address

40 Old Route 202a
Pomona, NY 10970-2848
Phone (845) 354-6619

Other identifiers 1

IdentifierTypeStateIssuer
00683270MedicaidNY

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
I20160105000521 NY Order and Referring Only - DentistPractitioner - Dentist 5698077956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8358GAMDGeneral Practice Dentistry
5814MDMDGeneral Practice Dentistry
11450NJMDGeneral Practice Dentistry
31155NYMDGeneral Practice Dentistry
4655VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1992788103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 OLD ROUTE 202A",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109702848",
            "telephone_number": "845-354-6619",
            "fax_number": "845-354-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 OLD ROUTE 202A",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109702848",
            "telephone_number": "845-354-6619",
            "fax_number": "845-354-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "31155",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "11450",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "8358",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "5814",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "4655",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00683270",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NY

Sources for this page

Verify at the official NPI Registry.