Kathleen Malico, RDH,BSDH,OMT

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

159061 Issued in NY

Practice address

15 Lone Oak CT
Centerport, NY 11721-1451

Phone

(631) 385-8963

NPI assigned

Nov 19, 2016

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 19, 2016.

{
    "created_epoch": "1479513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479513600000",
    "number": "1669915898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LONE OAK CT",
            "city": "CENTERPORT",
            "state": "NY",
            "postal_code": "117211451",
            "telephone_number": "631-385-8963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 LONE OAK CT",
            "city": "CENTERPORT",
            "state": "NY",
            "postal_code": "117211451",
            "telephone_number": "631-385-8963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALICO",
        "first_name": "KATHLEEN",
        "credential": "RDH,BSDH,OMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-19",
        "last_updated": "2016-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NY",
            "license": "159061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Michael Levy, MSW NY LCSW
• Anne Long
• Jennifer Lopez
• Jeanette Lukas, LCSW, DSW
• Sunita Mohan Makhijani, M.D.
• Katharine Jane Mann, D.C.
• Rosemary Alice Marcaccio, LCSW
• Kellie A Martin-Mendonis
• Joshua Aaron May, M.S., BCBA, LBA
• Tara May

• All providers in Centerport, NY
• Dental Hygienist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2016; 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.