Individual provider Active NPI

Charles M Fliegler, DDS

  • Dentist
  • Kingston, NY
National Provider Identifier
1679782940
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
029231 Issued in NY
Practice address
138 Pine St
Pine Street Dental
Kingston, NY 12401-4947
Phone
(845) 339-6900
Fax
(845) 338-6013
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 029231 NY Primary

Addresses

Primary practice location

138 Pine St
Pine Street Dental
Kingston, NY 12401-4947

Mailing address

138 Pine St
Pine Street Dental
Kingston, NY 12401-4947
Phone (845) 339-6900

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
I20170405000922 NY Order and Referring Only - DentistPractitioner - Dentist 0143549139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029231NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679782940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 PINE ST",
            "address_2": "PINE STREET DENTAL",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014947",
            "telephone_number": "845-339-6900",
            "fax_number": "845-338-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 PINE ST",
            "address_2": "PINE STREET DENTAL",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014947",
            "telephone_number": "845-339-6900",
            "fax_number": "845-338-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLIEGLER",
        "first_name": "CHARLES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "029231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.