Kenneth Paul Doaltowski, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

032859-1 Issued in NY

Practice address

2105 W Genesee St
Suite 207
Syracuse, NY 13219-1656

Phone

(315) 468-0031

Fax

(315) 487-3599

NPI assigned

Jun 4, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1598967440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 EMANN DR",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313011",
            "telephone_number": "315-487-1270",
            "fax_number": "315-487-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 W GENESEE ST",
            "address_2": "SUITE 207",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132191656",
            "telephone_number": "315-468-0031",
            "fax_number": "315-487-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOALTOWSKI",
        "first_name": "KENNETH",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "032859-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00447374",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian Djanie, CRNA
• Alem Djukic, NP
• Ruth B. Dlamini-Ndeze, CNM
• DMC Consultant Group, Wbe LLC
• Tina DO
• Jennie Marie Doane, NP-C
• Margaret Anne Dobbins, RN
• David F. Dobies, M.D.
• Debra Dobransky
• James Dodd, CSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.