Kimberly Amanda Carstens

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

061156-01 Issued in NY

Practice address

549 Broadway Ste 102
Massapequa, NY 11758-5012

Phone

(516) 541-7600

NPI assigned

Mar 29, 2019

Last updated

Nov 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Dental Care of Massapequa P.C.

  • Dental Clinic/Center
  • Massapequa, NY
  • NPI 1053189555
  NPD Authorized official

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1326509456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 BROADWAY STE 102",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585012",
            "telephone_number": "516-551-4657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 BROADWAY STE 102",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585012",
            "telephone_number": "516-541-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSTENS",
        "first_name": "KIMBERLY",
        "middle_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061156-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawnell Carroll
• Katherine Ann Carroll, PA-C
• Michael P Carroll, MD
• Samantha Taylor Carroll, RN
• Donna Marie Carson, LCSW
• Melissa Joy Cartagena, DDS
• Katherine Frances Caruso, LMT
• Susan Casey
• Cassandra Martinez, Licensed Behavior Analyst (Precision ABA Therapy)
• James William Cassillo, DC

• General Practice Dentistry in Massapequa, NY
• Providers in Massapequa, 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 Nov 3, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.