Individual provider Active NPI

Daniella Renee Kirshner

  • Dentist
  • Roslyn, NY
National Provider Identifier
1710483425
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
060645 Issued in NY
Practice address
1044 Northern Blvd Ste 106
Roslyn, NY 11576-1507
Phone
(516) 721-6515
NPI assigned
Apr 2, 2018
Last updated
Jun 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 060645 NY Primary

Addresses

Primary practice location

1044 Northern Blvd Ste 106
Roslyn, NY 11576-1507

Mailing address

80 Clover Dr
Great Neck, NY 11021-1030
Phone (516) 721-6515

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
060645NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1710483425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 CLOVER DR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211030",
            "telephone_number": "516-721-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 NORTHERN BLVD STE 106",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761507",
            "telephone_number": "516-721-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSHNER",
        "first_name": "DANIELLA",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "060645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

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