Individual provider Active NPI

Steven F Kornhaber, DDS

  • Dentist
  • Port Washington, NY
National Provider Identifier
1427141761
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
036776 Issued in NY
Practice address
30 S Bayles Ave
Port Washington, NY 11050-3754
Phone
(516) 883-3311
Fax
(516) 883-6144
NPI assigned
Oct 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 036776 NY Primary

Addresses

Primary practice location

30 S Bayles Ave
Port Washington, NY 11050-3754

Mailing address

30 S Bayles Ave
Port Washington, NY 11050-3754
Phone (516) 883-3311

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160420001037 NY Order and Referring Only - DentistPractitioner - Dentist 3577861863

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427141761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S BAYLES AVE",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503754",
            "telephone_number": "516-883-3311",
            "fax_number": "516-883-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S BAYLES AVE",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503754",
            "telephone_number": "516-883-3311",
            "fax_number": "516-883-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNHABER",
        "first_name": "STEVEN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "036776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

Verify at the official NPI Registry.