Individual provider Active NPI

Kristen G Blumberger, DMD

  • Dentist
  • New York, NY
National Provider Identifier
1154441707
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
049321 Issued in NY
Practice address
60 E 42ND St
1521
New York, NY 10165-0006
Phone
(212) 697-1094
Fax
(212) 682-0838
NPI assigned
Mar 29, 2007
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
Dentist 122300000X 049321 NY Primary

Addresses

Primary practice location

60 E 42ND St
1521
New York, NY 10165-0006

Mailing address

60 E 42ND St
New York, NY 10165-0006
Phone (212) 697-1094

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
049321NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154441707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 E 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101650006",
            "telephone_number": "212-697-1094",
            "fax_number": "212-682-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 E 42ND ST",
            "address_2": "1521",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101650006",
            "telephone_number": "212-697-1094",
            "fax_number": "212-682-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMBERGER",
        "first_name": "KRISTEN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "049321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.