Individual provider Active NPI

Kathleen M Frost, DDS

  • Periodontics
  • Islip, NY
National Provider Identifier
1144240714
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
043727-0 Issued in NY
Practice address
150 Islip Ave
Suite 11
Islip, NY 11751-3222
Phone
(631) 581-3100
Fax
(631) 581-8164
NPI assigned
Jul 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 043727-0 NY Primary

Addresses

Primary practice location

150 Islip Ave
Suite 11
Islip, NY 11751-3222

Mailing address

150 Islip Ave
Suite 11
Islip, NY 11751-3222
Phone (631) 581-3100

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
I20151104002206 NY Order and Referring Only - DentistPractitioner - Dentist 5294045167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043727-0NYMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Kathleen M. Frost, DDS PC Periodontics CurrentSince Jan 17, 2021 Accepting new patients

Locations

150 Islip Ave
Ste 11
Islip, NY 11751
Phone (631) 581-3100

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144240714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 ISLIP AVE",
            "address_2": "SUITE 11",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513222",
            "telephone_number": "631-581-3100",
            "fax_number": "631-581-8164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 ISLIP AVE",
            "address_2": "SUITE 11",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513222",
            "telephone_number": "631-581-3100",
            "fax_number": "631-581-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROST",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "043727-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Islip, NY

Sources for this page

Verify at the official NPI Registry.