Individual provider Active NPI

Lloyd Kenneth Klausner, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • New York, NY
National Provider Identifier
1760545420
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
042166 Issued in NY
Practice address
30 Central Park S
Suite 3C
New York, NY 10019-1628
Phone
(212) 888-8889
Fax
(646) 264-0015
NPI assigned
Dec 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 042166 NY Primary

Addresses

Primary practice location

30 Central Park S
Suite 3C
New York, NY 10019-1628

Mailing address

118 Deepwood Rd
Roslyn Heights, NY 11577-1624
Phone (516) 484-7388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150212001665 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8628973369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042166NYMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1166313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760545420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 DEEPWOOD RD",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115771624",
            "telephone_number": "516-484-7388",
            "fax_number": "646-264-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CENTRAL PARK S",
            "address_2": "SUITE 3C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191628",
            "telephone_number": "212-888-8889",
            "fax_number": "646-264-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAUSNER",
        "first_name": "LLOYD",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "042166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.