Individual provider Active NPI

Hariram R. Kabra, DDS

  • General Practice Dentistry
  • Castleton, NY
National Provider Identifier
1053300533
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
034677-1 Issued in NY
Practice address
2500 Pondview Rd
Suite 201
Castleton, NY 12033
Phone
(518) 477-7537
Fax
(518) 477-6757
NPI assigned
Oct 18, 2005
Last updated
Oct 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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 034677-1 NY Primary

Addresses

Primary practice location

2500 Pondview Rd
Suite 201
Castleton, NY 12033

Mailing address

2500 Pondview Rd
Suite 201
Castleton, NY 12033
Phone (518) 477-7537

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
I20160609001370 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6103116736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034677-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1053300533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 PONDVIEW RD",
            "address_2": "SUITE 201",
            "city": "CASTLETON",
            "state": "NY",
            "postal_code": "12033",
            "telephone_number": "518-477-7537",
            "fax_number": "518-477-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 PONDVIEW RD",
            "address_2": "SUITE 201",
            "city": "CASTLETON",
            "state": "NY",
            "postal_code": "12033",
            "telephone_number": "518-477-7537",
            "fax_number": "518-477-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABRA",
        "first_name": "HARIRAM",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "034677-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castleton, NY

Sources for this page

Verify at the official NPI Registry.