Active NPI
Kathleen Mary Englehardt, DDS
- Endodontics
- Garden City, NY
National Provider Identifier
1275731465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 053314-1
- Practice address
- 877 Stewart Ave
Garden City, NY 11530-4803 - Phone
- (516) 222-1717
- NPI assigned
- Jul 10, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 053314-1 | NY | Primary |
Addresses
Primary practice location
877 Stewart Ave
Garden City, NY 11530-4803
Mailing address
647 Commack Rd
Commack, NY 11725-5414
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 |
|---|---|---|---|
| 053314-1 | NY | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276128000000",
"number": "1275731465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "647 COMMACK RD",
"city": "COMMACK",
"state": "NY",
"postal_code": "117255414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "877 STEWART AVE",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115304803",
"telephone_number": "516-222-1717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGLEHARDT",
"first_name": "KATHLEEN",
"middle_name": "MARY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-10",
"last_updated": "2010-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NY",
"license": "053314-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.