Organization Active NPI

Lillian Kelner DDS PC

  • Dental Clinic/Center
  • Staten Island, NY
National Provider Identifier
1699898072
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
261QD0000X Issued in NY
Legal business name
LILLIAN KELNER DDS PC
Practice address
430 Seaview Ave
Staten Island, NY 10305-3401
Phone
(718) 980-0844
NPI assigned
Apr 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Lillian Kelner, DDS
Title
Dentist
Phone
(718) 980-0844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 261QD0000X NY Primary

Addresses

Primary practice location

430 Seaview Ave
Staten Island, NY 10305-3401

Mailing address

430 Seaview Ave
Staten Island, NY 10305-3401
Phone (718) 980-0844

Other identifiers 2

IdentifierTypeStateIssuer
02145811MedicaidNY
1664405411OtherNYNPI PERSONAL

National Provider Directory

National Provider Directory

Locations

430 Seaview Ave
Staten Island, NY 10305
Phone (718) 980-0844

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699898072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053401",
            "telephone_number": "718-980-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053401",
            "telephone_number": "718-980-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILLIAN KELNER DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELNER",
        "authorized_official_first_name": "LILLIAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "718-980-0844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "261QD0000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02145811",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI PERSONAL",
            "identifier": "1664405411",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.