Paige Backenstose, DDS

Individual provider Active NPI General Practice Dentistry · Kingston, NY

NPI 1164041935 · NPPES record last updated Apr 13, 2020

Key facts

NPI
1164041935
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
060768 (NY)
Practice address
139 Pine St Ste 210
Kingston, NY 12401-4901
Phone
(845) 338-6900
NPI assigned
Apr 13, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
060768NYMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 060768 NY Yes

Addresses

Primary practice location

139 Pine St Ste 210
Kingston, NY 12401-4901

Mailing address

139 Pine St Ste 210
Kingston, NY 12401-4901
Phone (845) 338-6900

Other providers in Kingston, NY

All providers in Kingston, NY · General Practice Dentistry in New York

Sources for this page

Verify at the official NPI Registry.