Individual provider Active NPI

Dmitriy Kuznetsov, D.D.S.

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1477950467
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
058145 Issued in NY
Practice address
145 E 15TH St Apt 1E
New York, NY 10003-3532
Phone
(212) 475-7947
Fax
(212) 475-7952
NPI assigned
Nov 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 058145 NY Primary

Addresses

Primary practice location

145 E 15TH St Apt 1E
New York, NY 10003-3532

Mailing address

145 E 15TH St Apt 1E
New York, NY 10003-3532
Phone (212) 475-7947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Mar 26, 2016 through Mar 26, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
058145NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. K. Dental P.C. Past Accepting new patients

Organizations & group practices 1

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": "1416355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1477950467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E 15TH ST APT 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033532",
            "telephone_number": "212-475-7947",
            "fax_number": "212-475-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 E 15TH ST APT 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033532",
            "telephone_number": "212-475-7947",
            "fax_number": "212-475-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUZNETSOV",
        "first_name": "DMITRIY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-19",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.