Kyle Estelle, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22DI02660800 Issued in NJ

Practice address

634 Anderson Ave
Cliffside Park, NJ 07010-1811

Phone

(201) 945-1119

NPI assigned

Jun 3, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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 and National Provider Directory roles.

• DS Dental Arts

  • Pediatric Dentistry
  • Cliffside Park, NJ
  • NPI 1982856357
  NPD (past)

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1730537440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 7TH ST APT 1L",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073021838",
            "telephone_number": "631-252-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 ANDERSON AVE",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101811",
            "telephone_number": "201-945-1119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Bergen St",
            "address_2": "Room D716",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032495",
            "country_code": "US",
            "telephone_number": "973-972-4621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTELLE",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-03",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": "DR02970",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02660800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emergimed LLC
• Emergimed PC
• Energy Zone Wellness Center LLC
• Younghyon Eom
• Essgeekay Corp
• Ashraf Faltas
• George Fanous
• Alexander Farinola, DC
• Mohamed Fathelbab
• Yev Fedosenko, D.P.T

• Pediatric Dentistry in Cliffside Park, NJ
• Providers in Cliffside Park, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; 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.