Roger M Gershon, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

029058 Issued in NY

Practice address

871 5TH Ave
New York, NY 10065-4953

Phone

(212) 249-9523

Fax

(212) 650-9599

NPI assigned

Dec 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 29, 2015 through Dec 29, 2027

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1198281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198281600000",
    "number": "1992989271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654953",
            "telephone_number": "212-249-9523",
            "fax_number": "212-650-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654953",
            "telephone_number": "212-249-9523",
            "fax_number": "212-650-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSHON",
        "first_name": "ROGER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-22",
        "last_updated": "2007-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "029058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Gershon, DDS
• Andrew Martin Berger Gershon, DDS
• Anne Gershon
• Blake Spencer Gershon, MD
• David Gershon, MD
• Jacob Gershoni
• Dafna Gershoony, PA-C
• Judith Ellen Gershowitz, M.D.
• Julie Gershun, M.D.
• Andrea Gerson

• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.