Paul A Kosarin, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22406 Issued in NY

Practice address

1228 Wantagh Ave
Wantagh, NY 11793-2209

Phone

(516) 785-0730

Fax

(516) 785-0298

NPI assigned

May 21, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Paul A Kosarin Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 15, 2016 through Mar 15, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1295944866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 WANTAGH AVE",
            "address_2": "202",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932209",
            "telephone_number": "516-785-0730",
            "fax_number": "516-785-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932209",
            "telephone_number": "516-785-0730",
            "fax_number": "516-785-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSARIN",
        "first_name": "PAUL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "22406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "112236923",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "KOSARIN",
            "middle_name": "A",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• John King
• Debra Kirby
• Erica Klein-Saravis
• Sharon Lynn Klein, LCSW
• Jaclyn Kolkhorst
• Amber Krakoff
• Jenifer Kim Kramer, MD
• Laura Kranenberg, LCSW
• Thomas J Krassner
• Gretchen E Kretkowski-Rieger, PMHNP

• General Practice Dentistry in Wantagh, NY
• Providers in Wantagh, 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 Apr 29, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.