Active NPI
Family Dentistry
- General Practice Dentistry
- Albany, NY
National Provider Identifier
1053582908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 026473-1
- Legal business name
- FAMILY DENTISTRY
- Practice address
- 489 Western Ave
Albany, NY 12203 - Phone
- (518) 438-8161
- Fax
- (518) 438-8123
- NPI assigned
- Mar 19, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kenneth Kelman, DDS
- Title
- Owner
- Phone
- (518) 438-8161
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 026473-1 | NY | Primary |
Addresses
Primary practice location
489 Western Ave
Albany, NY 12203
Mailing address
489 Western Ave
Albany, NY 12203
Phone (518) 438-8161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00393031 | Medicaid | NY |
National Provider Directory
National Provider DirectoryLocations
489 Western Ave
Albany, NY 12203
Phone (518) 438-8161
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205884800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1216252800000",
"number": "1053582908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "489 WESTERN AVE",
"city": "ALBANY",
"state": "NY",
"postal_code": "12203",
"telephone_number": "518-438-8161",
"fax_number": "518-438-8173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "489 WESTERN AVE",
"city": "ALBANY",
"state": "NY",
"postal_code": "12203",
"telephone_number": "518-438-8161",
"fax_number": "518-438-8123"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY DENTISTRY",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-19",
"last_updated": "2008-07-17",
"status": "A",
"authorized_official_last_name": "KELMAN",
"authorized_official_first_name": "KENNETH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "518-438-8161",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "026473-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00393031",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.