Individual provider Active NPI

Barry S Kayne, DDS

  • Periodontics
  • Newark, DE
National Provider Identifier
1104945609
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
884 Issued in DE
Practice address
The Omega Professional Center
Ste F58
Newark, DE 19713
Phone
(302) 456-0400
Fax
(302) 456-0396
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 884 DE Primary

Addresses

Primary practice location

The Omega Professional Center
Ste F58
Newark, DE 19713

Mailing address

The Omega Professional Center
Ste F58
Newark, DE 19713
Phone (302) 456-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20151217002433 DE Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1759682636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
884DEMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1104945609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "THE OMEGA PROFESSIONAL CENTER",
            "address_2": "STE F58",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-456-0400",
            "fax_number": "302-456-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE OMEGA PROFESSIONAL CENTER",
            "address_2": "STE F58",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-456-0400",
            "fax_number": "302-456-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYNE",
        "first_name": "BARRY",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "DE",
            "license": "884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.