Individual provider Active NPI

Julie Montgomery Heidt Kreitzberg, D.M.D.

  • Dentist
  • Commack, NY
National Provider Identifier
1407195662
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
057302 Issued in NY
Practice address
353 Veterans Memorial Hwy
Commack, NY 11725-4200
Phone
(631) 543-5555
NPI assigned
Feb 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 057302 NY Primary

Addresses

Primary practice location

353 Veterans Memorial Hwy
Commack, NY 11725-4200

Mailing address

353 Veterans Memorial Hwy
Commack, NY 11725-4200
Phone (631) 543-5555

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
057302NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1407195662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 VETERANS MEMORIAL HWY",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254200",
            "telephone_number": "631-543-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 VETERANS MEMORIAL HWY",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254200",
            "telephone_number": "631-543-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREITZBERG",
        "first_name": "JULIE",
        "middle_name": "MONTGOMERY HEIDT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-07",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.