Kenneth M. Li, DDS
Individual provider Active NPI General Practice Dentistry · East Brunswick, NJ
NPI 1669675930 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1669675930
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DI 13712 (NJ)
- Practice address
- 45 Brunswick Woods Dr
East Brunswick, NJ 08816-5601 - Phone
- (732) 238-0457
- Fax
- (732) 238-1396
- NPI assigned
- Jun 6, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI 13712 | NJ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kenneth M. Li, DDS, PA | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DI 13712 | NJ | Yes |
Addresses
Primary practice location
45 Brunswick Woods Dr
East Brunswick, NJ 08816-5601
Mailing address
45 Brunswick Woods Dr
East Brunswick, NJ 08816-5601
Phone (732) 238-0457
Other providers in East Brunswick, NJ
- Isidora Izzy Lewis
- Tanesha Lewis
- Theresa Marie Lewis
- Albert C Li
- Dena Y Li
- Yan Li
- Sarah Liao
- Alan Sheldon Lichtbroun
- Tara Lichter
- Jeremy Lichtman
All providers in East Brunswick, NJ · General Practice Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.