Sergey Kuznetsov, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

052229-1 Issued in NY

Practice address

65 Oriental Blvd
LBB
Brooklyn, NY 11235-4945

Phone

(718) 769-6777

Fax

(718) 769-6775

NPI assigned

Apr 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr. K. Dental P.C.

  • Dental Clinic/Center
  • New York, NY
  • NPI 1487147757
  NPD Authorized official

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383350400000",
    "number": "1164641122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E 15TH ST",
            "address_2": "SUITE 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033531",
            "telephone_number": "212-475-7947",
            "fax_number": "212-475-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 ORIENTAL BLVD",
            "address_2": "LBB",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354945",
            "telephone_number": "718-769-6777",
            "fax_number": "718-769-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUZNETSOV",
        "first_name": "SERGEY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2013-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052229-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02698951",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dmitry Kuzmin, D.O.
• Margaryta Kuzmin
• Sarah Kuzmina
• Yulia Kuzmitskaya
• Sergei A Kuznetsov, DDS, MD
• Valery Kuznetsov, M.D.
• Anna Kuznetsova, PT
• Elena Kuznetsova
• Kristina Kuznetsova
• Kseniia Kuznetsova

• General Practice Dentistry in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.