DR. RITA SUSAN O'DWYER (NPI# 1114450327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114450327 |
| Entity Type | Individual |
| Full Name | DR. RITA SUSAN O'DWYER |
| Credential | DDS |
| Practice Address |
2500 Nesconset Hwy Bldg 18a Stony Brook NY 11790-2563 |
| Mailing Address |
Po Box 143 Saint James NY 11780-0143 |
| Practice Telephone | 6317511400 |
| Mailing Telephone | 6317601048 |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2020-09-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
059772 | NY | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
059772 | NY | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 506 6th St, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY 112153609 | 7187803000 | |
| 705 Hawkins Ave, Lake Ronkonkoma, NY 11779 | 6319815150 | |
| 2013 Wantagh Ave, Wantagh, NY 117933920 | 5168266655 |
| Street Address |
2500 NESCONSET HWY BLDG 18A |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11790-2563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184709123 | Jerome Cymerman | Dentist | 2500 Nesconset Hwy Bldg 18a, Stony Brook, NY 11790-2563 | 2006-10-26 |
| 1598029779 | Advanced Endodontics of Long Island, P.C. | Dentist | 2500 Nesconset Hwy Bldg 18a, Stony Brook, NY 11790-2563 | 2012-07-02 |
| 1619110996 | Brian Mccormack | Dentist | 2500 Nesconset Hwy Bldg 18a, Stony Brook, NY 11790-2563 | 2009-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649807678 | Ribu Mathew | Student in an Organized Health Care Education/Training Program | Health Science Center T16, Room 020, Stony Brook, NY 11790 | 2020-03-27 |
| 1538794821 | Chaoyang Qu | Student in an Organized Health Care Education/Training Program | 9 Syncamore Dr, Stonybrook, NY 11790 | 2020-03-06 |
| 1457814824 | Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 | 2019-04-11 |
| 1447759741 | Susan Cuccia | Registered Nurse | 40 Sheppard Lane, Stony Brook, NY 11790 | 2018-02-02 |
| 1972022234 | Carol M Doherty | Specialist | 7 Haskel Lane, Stony Brook, NY 11790 | 2017-09-18 |
| 1972021582 | Louren M Gonzales | Nurse Practitioner | 100 Nicolls Rd Hsc Level 4 Room 120, Hsc Level 4 Room 120, Stony Brook, NY 11790 | 2017-09-04 |
| 1043740954 | Asma Khattak | Behavior Technician | 90 Quaker Path, Stony Brook, NY 11790 | 2017-06-13 |
| 1427452846 | Christina Georgia | Registered Nurse | 36 Ivy League Lane, Stony Brook, NY 11790 | 2014-10-14 |
| 1124361654 | Mandeep Kainth | Student in an Organized Health Care Education/Training Program | Department of Medicine Hsc Level 16, 020, Suny Stony Brook, Stony Brook, NY 11790 | 2013-04-03 |
| 1922357144 | Audry M Luciano | Registered Nurse | 2500 Nesconset Hwy Bldg 23, Stony Brook, NY 11790 | 2012-09-04 |
| Find all providers in zip 11790 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780868430 | George Anthony Bruder IIi | Dentist | Stony Brook Dental Associates Inc, Sullivan Hall - Room 170 - Faculty Practice, Stony Brook, NY 11794-8705 | 2007-12-18 |
| 1184709123 | Jerome Cymerman | Dentist | 2500 Nesconset Hwy Bldg 18a, Stony Brook, NY 11790-2563 | 2006-10-26 |
| 1598029779 | Advanced Endodontics of Long Island, P.C. | Dentist | 2500 Nesconset Hwy Bldg 18a, Stony Brook, NY 11790-2563 | 2012-07-02 |
| 1518226265 | Tej Vaidya | Dentist | Stony Brook University Hospital, Medical/house Staff Svc. Dept. 9-110, Stony Brook, NY 11794-0001 | 2012-05-15 |
| 1619110996 | Brian Mccormack | Dentist | 2500 Nesconset Hwy Bldg 18a, Stony Brook, NY 11790-2563 | 2009-04-15 |
| 1285882340 | James L Kantor | Dentist | Stony Brook University, Rockland Hall Room 140, Stony Brook, NY 11794-0001 | 2008-09-03 |
| 1629252507 | Shin Chieh Yang | Dentist | Stony Brook University Hospital, Medical House Staff Office, Stony Brook, NY 11794-0001 | 2007-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026235 | Sanghyun Park | Dentist | 1103 Stewart Ave Ste 104, Garden City, NY 11530-4886 | 2020-09-03 |
| 1164031654 | Harp Endodontics PC | Dentist | 121 E 60th St Apt 10a, New York, NY 10022-1198 | 2020-07-30 |
| 1518590918 | All County Endodontics, PC | Dentist | 112 Westminster Rd, Scarsdale, NY 10583-2425 | 2020-02-14 |
| 1245862325 | Marie Milagros Mora Moreno | Dentist | 345 E 24th St Dept Of, New York, NY 10010-4020 | 2020-02-06 |
| 1407406218 | Geoffrey Louis Sas | Dentist | 1414 Avenue of The Americas Fl 19, New York, NY 10019-2514 | 2019-09-13 |
| 1790340875 | Kim & Wang Dds Pllc | Dentist | 10737 71st Ave Ste 203, Forest Hills, NY 11375-4736 | 2019-05-05 |
| 1003373903 | Prohealth Dental Pllc | Dentist | 5011 Vernon Blvd, Long Island City, NY 11101 | 2019-02-27 |
| 1023575982 | Prohealth Dental Pllc | Dentist | 16345 Crossbay Blvd, Howard Beach, NY 11414-3741 | 2019-02-27 |
| 1114494911 | Alf Hitel Bunes | Dentist | 900 Starboard Side Ln Apt 306, Webster, NY 14580-2288 | 2018-10-30 |
| 1972086684 | Steven Kyongmin Kim | Dentist | 209 E 56th St Frnt 1, New York, NY 10022 | 2018-09-09 |
| Find all providers with the same taxonomy | ||||
| City | STONY BROOK |
| Zip Code | 11790 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.