Individual provider Active NPI

Lily Zhang, DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Kingston, NY
National Provider Identifier
1689655813
Registry record updated Jan 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
045352 Issued in NY
Practice address
40 Hurley Ave
Suite 11
Kingston, NY 12401-3739
Phone
(845) 339-0964
NPI assigned
Nov 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 045352 NY Primary
General Practice Dentistry 1223G0001X 045352 NY

Addresses

Primary practice location

40 Hurley Ave
Suite 11
Kingston, NY 12401-3739

Mailing address

40 Hurley Ave
Suite 11
Kingston, NY 12401-3739
Phone (845) 339-0964

Other identifiers 1

IdentifierTypeStateIssuer
045352OtherNYDENTAL LISENCE

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
I20230220001209 NY Practitioner - Oral Surgery 6305218405 Practice locations: Kingston, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045352NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Lily Zhang, DMD General Practice PastSince Nov 15, 2022 Accepting new patients
David Lee DDS PLLC General Practice PastSince Nov 3, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674864000000",
    "number": "1689655813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HURLEY AVE",
            "address_2": "SUITE 11",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013739",
            "telephone_number": "845-339-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HURLEY AVE",
            "address_2": "SUITE 11",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013739",
            "telephone_number": "845-339-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHANG",
        "first_name": "LILY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-05",
        "last_updated": "2023-01-28",
        "certification_date": "2023-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "045352",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045352",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LISENCE",
            "identifier": "045352",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.