JACOB EISDORFER D.D.S. NPI 1881919728

NPI Information

NPI: 1881919728
Provider Name: JACOB EISDORFER, D.D.S.
Classification: Dentist - 1223D0004X
Entity Type: Individual

Specialization: Dentist Anesthesiologist

Address:
1162 42ND ST
BROOKLYN, NY
ZIP 11219
Phone: (347) 209-7158
Get Directions

Jacob Eisdorfer, D.D.S. is a dentist anesthesiologist dentist in Brooklyn, NY. The provider is a dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. Jacob Eisdorfer, D.D.S. NPI is 1881919728. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1162 42ND ST
BROOKLYN, NY
ZIP 11219-213
Phone: (347) 209-7158

The enumeration date for this NPI number is 4/4/2010 and was last updated on 3/24/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223D0004X	Dentist	Dentist Anesthesiologist	22DI02480400	NEW JERSEY	No
2	122300000X	Dentist		00055621	NEW YORK	No
3	122300000X	Dentist		22DI02480400	NEW JERSEY	No
4	1223D0004X	Dentist	Dentist Anesthesiologist	00055621	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	03355406	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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