Lena Khaylomsky, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22424 Issued in NJ

Practice address

4100 Park Ave
Weehawken, NJ 07086-6196

Phone

(201) 348-1616

Fax

(201) 348-4877

NPI assigned

Sep 30, 2008

Sex

Female

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

• Lena Khaylomsky Professional name

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1417107178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 PARK AVE",
            "city": "WEEHAWKEN",
            "state": "NJ",
            "postal_code": "070866196",
            "telephone_number": "201-348-1616",
            "fax_number": "201-348-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 PARK AVE",
            "city": "WEEHAWKEN",
            "state": "NJ",
            "postal_code": "070866196",
            "telephone_number": "201-348-1616",
            "fax_number": "201-348-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAYLOMSKY",
        "first_name": "LENA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0038792",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LENA",
            "last_name": "KHAYLOMSKY",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• General Practice Dentistry in Weehawken, NJ
• Providers in Weehawken, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.