Active NPI
Kenneth Shyer Kornman, DDS
- Dentist
- Newton, MA
National Provider Identifier
1184128399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN20155
- Practice address
- 920 Centre St
Newton, MA 02459-1236 - Phone
- (617) 244-9940
- Fax
- (617) 244-9941
- NPI assigned
- Mar 21, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN20155 | MA | Primary |
Addresses
Primary practice location
920 Centre St
Newton, MA 02459-1236
Mailing address
920 Centre St
Newton, MA 02459-1236
Phone (617) 244-9940
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN20155 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521590400000",
"number": "1184128399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 CENTRE ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024591236",
"telephone_number": "617-244-9940",
"fax_number": "617-244-9941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 CENTRE ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024591236",
"telephone_number": "617-244-9940",
"fax_number": "617-244-9941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORNMAN",
"first_name": "KENNETH",
"middle_name": "SHYER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-21",
"last_updated": "2018-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "MA",
"license": "DN20155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.