Individual provider Active NPI

Kimberly Rebhun, D.D.S

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • New City, NY
National Provider Identifier
1295181931
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
059349 Issued in NY
Practice address
339 N Main St Ste 7-8
New City, NY 10956-4300
Phone
(845) 558-2067
NPI assigned
May 12, 2016
Last updated
May 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 059349 NY
Dentist 122300000X 22DI02745800 NJ
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 059349 NY Primary

Addresses

Primary practice location

339 N Main St Ste 7-8
New City, NY 10956-4300

Mailing address

3745 Cardiff Ave Apt 410
Los Angeles, CA 90034-3452

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

LicenseStateTypeSpecialty
22DI02745800NJMDDentist
059349NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1295181931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3745 CARDIFF AVE APT 410",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900343452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 N MAIN ST STE 7-8",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564300",
            "telephone_number": "845-558-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBHUN",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "059349",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02745800",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "059349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.