Glen Kreitzberg, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

036804 Issued in NY

Practice address

353 Veterans Memorial Hwy
Suite 202
Commack, NY 11725-4200

Phone

(631) 543-5555

Fax

(631) 543-5556

NPI assigned

Jul 17, 2014

Last updated

Jul 17, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Glen R. Kreitzberg D.D.S.,P.C.

  • Dental Clinic/Center
  • Commack, NY
  • NPI 1881670883
  NPD (past) Authorized official

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1710394101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 202",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254200",
            "telephone_number": "631-543-5555",
            "fax_number": "631-543-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 202",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254200",
            "telephone_number": "631-543-5555",
            "fax_number": "631-543-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREITZBERG",
        "first_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "036804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Koven, PHARMD
• Melissa Koziatek, NP-C
• Sarah Kramer
• Gerald Herbert Kreinces, DMD
• Dustin Halden Kreitzberg, D.D.S.
• Julie Montgomery Heidt Kreitzberg, D.M.D.
• David L. Kreitzman, M.D.
• Barbara Allison Kressel, CCCSLP
• Stuart Krieger, O.D.
• Caitlin Krohmer

• Dentist in Commack, NY
• Providers in Commack, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.