Individual provider Active NPI

Boris Kleyman, D.D.S.

  • Pediatric Dentistry
  • Fair Lawn, NJ
National Provider Identifier
1386901262
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
22DI02600000 Issued in NJ
Practice address
25-15 Broadway
Fair Lawn, NJ 07410-3813
Phone
(732) 803-1948
NPI assigned
Apr 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15370 MD
General Practice Dentistry 1223G0001X DEN1001129 DC
Pediatric Dentistry 1223P0221X 22DI02600000 NJ Primary

Addresses

Primary practice location

25-15 Broadway
Fair Lawn, NJ 07410-3813

Mailing address

25-15 Broadway
Fair Lawn, NJ 07410-3813
Phone (732) 803-1948

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
DEN1001129DCMDGeneral Practice Dentistry
22DI02600000NJMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
DDS Associates PC Current Accepting new patients
B&D Smile PC Current Accepting new patients
Bright Star Sapphire Therapy Current Accepting new patients
ABA Pediatric, LLC Pediatric Dentistry Past Accepting new patients

Locations

25-15 Broadway
Fair Lawn, NJ 07410
Phone (201) 254-2969

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1386901262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25-15 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103813",
            "telephone_number": "732-803-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25-15 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103813",
            "telephone_number": "732-803-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEYMAN",
        "first_name": "BORIS",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "15370",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN1001129",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02600000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.