Individual provider Active NPI

Kevin Sheren, DDS

  • General Practice Dentistry
  • Hampton Bays, NY
National Provider Identifier
1033133749
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
046780-1 Issued in NY
Practice address
182 W Montauk Hwy
Building B Suite E
Hampton Bays, NY 11946-2345
Phone
(631) 728-8400
Fax
(631) 728-8482
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 046780-1 NY Primary

Addresses

Primary practice location

182 W Montauk Hwy
Building B Suite E
Hampton Bays, NY 11946-2345

Mailing address

182 W Montauk Hwy
Building B Suite E
Hampton Bays, NY 11946-2345
Phone (631) 728-8400

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
I20150629002857 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8224218144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046780-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hampton Bays Dental Associates P.C. General Practice CurrentSince Dec 27, 2010 Accepting new patients
Madeline Shakin DDS Kevin Sheren DDS PC General Practice PastSince Dec 27, 2010 Accepting new patients

Locations

182 W Montauk Hwy
Ste E
Hampton Bays, NY 11946
Phone (631) 728-8400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033133749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 W MONTAUK HWY",
            "address_2": "BUILDING B SUITE E",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119462345",
            "telephone_number": "631-728-8400",
            "fax_number": "631-728-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 W MONTAUK HWY",
            "address_2": "BUILDING B SUITE E",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119462345",
            "telephone_number": "631-728-8400",
            "fax_number": "631-728-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEREN",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046780-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton Bays, NY

Sources for this page

Verify at the official NPI Registry.