Individual provider Active NPI

Aaron Kramer, DDS

  • General Practice Dentistry
  • Lake Ronkonkoma, NY
National Provider Identifier
1104810746
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
030227 Issued in NY
Practice address
516 Hawkins Ave
Lake Ronkonkoma, NY 11779-2374
Phone
(631) 588-9041
Fax
(631) 588-6772
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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 030227 NY Primary

Addresses

Primary practice location

516 Hawkins Ave
Lake Ronkonkoma, NY 11779-2374

Mailing address

8 Surrey Lane
East Setauket, NY 11733-3817
Phone (631) 981-4513

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
I20160427000118 NY Order and Referring Only - DentistPractitioner - Dentist 3678792272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030227NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1104810746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 SURREY LANE",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333817",
            "telephone_number": "631-981-4513",
            "fax_number": "631-981-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 HAWKINS AVE",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117792374",
            "telephone_number": "631-588-9041",
            "fax_number": "631-588-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAMER",
        "first_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "030227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ronkonkoma, NY

Sources for this page

Verify at the official NPI Registry.