Active NPI
Kenneth Philip Schob, DDS
- Dentist
- Rego Park, NY
National Provider Identifier
1629050968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 040245
- Practice address
- 97-07 63Rd Rd
Rego Park, NY 11374 - Phone
- (718) 896-2202
- NPI assigned
- Nov 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 040245 | NY | Primary |
Addresses
Primary practice location
97-07 63Rd Rd
Rego Park, NY 11374
Mailing address
16241 Powells Cove Blvd
Beechhurst, NY 11357-1449
Phone (718) 767-5128
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01040959 | Medicaid | NY |
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 |
|---|---|---|---|
| 040245 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1629050968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16241 POWELLS COVE BLVD",
"city": "BEECHHURST",
"state": "NY",
"postal_code": "113571449",
"telephone_number": "718-767-5128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "97-07 63RD RD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "11374",
"telephone_number": "718-896-2202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHOB",
"first_name": "KENNETH",
"middle_name": "PHILIP",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "040245",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01040959",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.