Individual provider Active NPI

Kathleen L. Agoglia, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1679634349
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
041295 Issued in NY
Practice address
1 Brookdale Plaza
Brookdale Hospital
Brooklyn, NY 11212
Phone
(718) 240-6283
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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 041295 NY Primary

Addresses

Primary practice location

1 Brookdale Plaza
Brookdale Hospital
Brooklyn, NY 11212

Mailing address

2270 E 74TH St
Brooklyn, NY 11234-6604
Phone (917) 613-8491

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
041295NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246838400000",
    "number": "1679634349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 E 74TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346604",
            "telephone_number": "917-613-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLAZA",
            "address_2": "BROOKDALE HOSPITAL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11212",
            "telephone_number": "718-240-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOGLIA",
        "first_name": "KATHLEEN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2009-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "041295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; 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.