Igor Khabensky, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

058143 Issued in NY

Practice address

1615 Quentin Rd Ste A1
Brooklyn, NY 11229-1295

Phone

(917) 846-5304

NPI assigned

Nov 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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 18, 2016 through Mar 18, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1316343387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2426 E 27TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352004",
            "telephone_number": "917-846-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 QUENTIN RD STE A1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291295",
            "telephone_number": "917-846-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHABENSKY",
        "first_name": "IGOR",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-18",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "058143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KFG Operating I, LLC
• KFG Operating Two, LLC
• KG Hollywood Smile Dental, PC
• KH Pain Associates of New York, LLP
• Alexander Khabensky, DDS
• Vrutika Khabia, PT
• Shelly Rachel Khabieh
• Shaya Khabyeh-Hasbani, M.D.
• Viktoria Khachatryan, OTR/L
• Levon Khacheryan, D.O.

• Dentist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.