Individual provider Active NPI

William J Kucko, DDS

  • General Practice Dentistry
  • Johnson City, NY
National Provider Identifier
1518181577
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
033924 Issued in NY
Practice address
226 Oakdale Rd
Johnson City, NY 13790-1127
Phone
(607) 729-6961
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
No

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
General Practice Dentistry 1223G0001X 033924 NY Primary

Addresses

Primary practice location

226 Oakdale Rd
Johnson City, NY 13790-1127

Mailing address

226 Oakdale Rd
Johnson City, NY 13790-1127
Phone (607) 729-6961

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
I20150609001228 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7719208263

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518181577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 OAKDALE RD",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901127",
            "telephone_number": "607-729-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 OAKDALE RD",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901127",
            "telephone_number": "607-729-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCKO",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "033924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.