Active NPI
Jennifer Ko, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Whitestone, NY
National Provider Identifier
1487035523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 058643
- Practice address
- 19925 22ND Ave
Whitestone, NY 11357-4121 - Phone
- (347) 255-5388
- NPI assigned
- Jun 15, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 058643 | NY | Primary |
Addresses
Primary practice location
19925 22ND Ave
Whitestone, NY 11357-4121
Mailing address
19925 22ND Ave
Whitestone, NY 11357-4121
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
| License | State | Type | Specialty |
|---|---|---|---|
| 058643 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627948800000",
"number": "1487035523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19925 22ND AVE",
"city": "WHITESTONE",
"state": "NY",
"postal_code": "113574121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19925 22ND AVE",
"city": "WHITESTONE",
"state": "NY",
"postal_code": "113574121",
"telephone_number": "347-255-5388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KO",
"first_name": "JENNIFER",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-15",
"last_updated": "2021-08-03",
"certification_date": "2021-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "058643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whitestone, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.