Active NPI
Ilan Kiselstein, DDS
- General Practice Dentistry
- Amarillo, TX
National Provider Identifier
1730553397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 31408
- Practice address
- 850 Martin Rd
Amarillo, TX 79107-6814 - Phone
- (806) 374-7341
- Fax
- (806) 322-2485
- NPI assigned
- Nov 19, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 31408 | TX | Primary |
Addresses
Primary practice location
850 Martin Rd
Amarillo, TX 79107-6814
Mailing address
2801 W 8TH St
Plainview, TX 79072-6737
Phone (806) 374-7341
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170124003198 | TX | Order and Referring Only - Other (Physician) | 7315229457 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485388800000",
"number": "1730553397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 W 8TH ST",
"city": "PLAINVIEW",
"state": "TX",
"postal_code": "790726737",
"telephone_number": "806-374-7341",
"fax_number": "806-322-2485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 MARTIN RD",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791076814",
"telephone_number": "806-374-7341",
"fax_number": "806-322-2485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISELSTEIN",
"first_name": "ILAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-19",
"last_updated": "2017-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "31408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
- Pamela M Kirby, PSY. D.
- Samuel E Kirkendall, M.D.
- Kirkland Court Health Care LLC (Kirkland Court Health and Rehabilitation Center)
- Jerry Lynn Kirkland, MD
- Patrick James Kirkland, M.D.
- Lawrence Edward Kitchens III
- Donna Raef Kizziar, APRN, FNP-C
- Mason Kizziar, APRN-FNP, RNFA, CST
- KJB Anesthesia, PLLC
- Katrina D'Ann Klaehn, MA, LPC, LSOTP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.