Individual provider Active NPI

Kellie Ann Alberry, D.D.S.

  • Pediatric Dentistry
  • Plainview, NY
National Provider Identifier
1053649541
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
054460 Issued in NY
Practice address
146A Manetto Hill Rd
Plainview, NY 11803-1323
Phone
(516) 931-7171
Fax
(516) 931-7107
NPI assigned
Nov 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 054460 NY Primary

Addresses

Primary practice location

146A Manetto Hill Rd
Plainview, NY 11803-1323

Mailing address

146A Manetto Hill Rd
Plainview, NY 11803-1323
Phone (516) 931-7171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
054460NYMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1053649541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146A MANETTO HILL RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031323",
            "telephone_number": "516-931-7171",
            "fax_number": "516-931-7107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146A MANETTO HILL RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031323",
            "telephone_number": "516-931-7171",
            "fax_number": "516-931-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBERRY",
        "first_name": "KELLIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-23",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "054460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.