Kenneth Lee Kobliner, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

36680 Issued in NY

Practice address

23 Bond Street
Great Neck, NY 11021-2025

Phone

(516) 482-2542

Fax

(516) 466-0651

NPI assigned

Apr 25, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

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

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164641296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 BOND STREET",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212025",
            "telephone_number": "516-482-2542",
            "fax_number": "516-466-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 BOND STREET",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212025",
            "telephone_number": "516-482-2542",
            "fax_number": "516-466-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBLINER",
        "first_name": "KENNETH",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "36680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Knaupp, CNS
• Knead Massage PC
• Robert Morris Knepper, D.D.S.
• Michael Knob, PT
• Lawrence Koblenz, MD
• Jamie Kobren
• Lawrence Jay Kobren, D.D.S.
• Steven Mark Kobren
• Jenny Kochupurackal, PHARM.D.
• Sylvia Rose Kodsi, MD

• Periodontics in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Periodontics in New York

• 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.
• 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.