Active NPI
Eli Kahn, DMD
- Dentist
- Canandaigua, NY
National Provider Identifier
1790004489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 055110
- Practice address
- 308 Eastern Blvd
Canandaigua, NY 14424 - Phone
- (585) 412-5040
- NPI assigned
- May 20, 2010
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 055110 | NY | Primary |
Addresses
Primary practice location
308 Eastern Blvd
Canandaigua, NY 14424
Mailing address
308 Eastern Blvd
Canandaigua, NY 14424
Phone (585) 412-5040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20160509002258 | FL | Order and Referring Only - Dentist | 2668771957 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055110 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346112000000",
"number": "1790004489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 EASTERN BLVD",
"city": "CANANDAIGUA",
"state": "NY",
"postal_code": "14424",
"telephone_number": "585-412-5040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 EASTERN BLVD",
"city": "CANANDAIGUA",
"state": "NY",
"postal_code": "14424",
"telephone_number": "585-412-5040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAHN",
"first_name": "ELI",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-20",
"last_updated": "2012-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "055110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canandaigua, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.