Individual provider Active NPI

Kathleen Schultz

  • Oral and Maxillofacial Pathology Dentistry
  • New Hyde Park, NY
National Provider Identifier
1043633365
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
060307 Issued in NY
Practice address
27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone
(860) 532-9299
NPI assigned
Jan 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 060307 NY
Oral and Maxillofacial Pathology Dentistry 1223P0106X 060307 NY Primary

Addresses

Primary practice location

27005 76TH Ave
New Hyde Park, NY 11040-1402

Mailing address

27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone (860) 532-9299

Other names 1

  • Kathleen Schultz Professional name

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190805001402 NY Practitioner - DentistPractitioner - Pathology 9830433937 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
DentistAlso: Pathology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black Hall Dental PCGroup PAC ID 6901283308, 8 clinicians
White Hall Dental, PCGroup PAC ID 2567820137, 10 clinicians

Practice addresses (Care Compare)

10 Medical PLZ
Suite 210
Glen Cove, NY 11542-2101
Phone (516) 674-7646

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (516) 304-7362

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
060307NYMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hall Dental, P.C. CurrentSince Apr 12, 2023 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jun 23, 2019 Accepting new patients
Black Hall Dental, P.C. CurrentSince Apr 12, 2023 Accepting new patients
White Hall Dental, PC Oral and Maxillofacial Pathology CurrentSince Jul 1, 2023 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jun 23, 2019 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

10 Medical Plz
Ste 210
Glen Cove, NY 11542
Phone (516) 671-2903

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: kschultz65753@northwell.direct-ci.com

Organizations & group practices 5

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": "1390348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1043633365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "860-532-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "860-532-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-22",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "060307",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": "060307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "SCHULTZ",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.