Kris Kotsay, DENTIST

Primary specialty

DentistTaxonomy code 122300000X

License

009330 Issued in CT

Practice address

64 Black Rock Ave
Bridgeport, CT 06605-1200

Phone

(203) 579-5223

Fax

(203) 332-0376

NPI assigned

Oct 20, 2005

Sex

Male

Sole proprietor

No

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

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1649269705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 BLACK ROCK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051200",
            "telephone_number": "203-579-5223",
            "fax_number": "203-332-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 BLACK ROCK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051200",
            "telephone_number": "203-579-5223",
            "fax_number": "203-332-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTSAY",
        "first_name": "KRIS",
        "credential": "DENTIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "009330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "009330",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Konecny Chiropractic Centers LLC
• Jonathan Peter Konecny, DC
• Katelyn Lee Koning, LPC
• Rithik Naik Korra, M.B.B.S
• Edward Kosinski, MD
• Uttara Koul, MD
• Ashley Nicole Kovac
• Heather Kovac, WHNP-BC
• Amanda Koval, MS, CDN
• Bruce Kovalenko, M.D.

• Dentist in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.