Individual provider Active NPI

Neil E Kesselman, DDS

  • General Practice Dentistry
  • Brewster, NY
National Provider Identifier
1629067798
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
035903 Issued in NY
Practice address
1620 Route 22
Brewster, NY 10509-4051
Phone
(845) 279-4999
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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 035903 NY Primary

Addresses

Primary practice location

1620 Route 22
Brewster, NY 10509-4051

Mailing address

1620 Route 22
Brewster, NY 10509-4051

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
I20150515000672 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9537489505

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1629067798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 ROUTE 22",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 ROUTE 22",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094051",
            "telephone_number": "845-279-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSELMAN",
        "first_name": "NEIL",
        "middle_name": "E",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "035903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

Verify at the official NPI Registry.