Individual provider Active NPI

Evan Judah Kollander, DDS

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1154854453
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
059995 Issued in NY
Practice address
800 Ocean Pkwy Ste Aa
Brooklyn, NY 11230-2124
Phone
(718) 633-4963
Fax
(718) 435-8916
NPI assigned
Apr 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 059995 NY Primary

Addresses

Primary practice location

800 Ocean Pkwy Ste Aa
Brooklyn, NY 11230-2124

Mailing address

525 E 68TH St # F-2132
New York, NY 10065-4870
Phone (516) 902-3537

Other practice location 1

2425 Kings Hwy Ste A10
Brooklyn, NY 11229-1639
Phone (718) 253-6605

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
059995NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Alan B. Kohn, D.D.S., P.C. Dentist PastSince Apr 10, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1154854453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST # F-2132",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "516-902-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 OCEAN PKWY STE AA",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112302124",
            "telephone_number": "718-633-4963",
            "fax_number": "718-435-8916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2425 Kings Hwy Ste A10",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112291639",
            "country_code": "US",
            "telephone_number": "718-253-6605",
            "fax_number": "718-435-8916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLLANDER",
        "first_name": "EVAN",
        "middle_name": "JUDAH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-04",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "059995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.