Active NPI
E. Michelle Kun, DDS
- Pediatric Dentistry
- Melville, NY
National Provider Identifier
1790839637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 474121
- Practice address
- 612 Walt Whitman Rd
Melville, NY 11747-2102 - Phone
- (631) 629-4490
- Fax
- (631) 629-4489
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 474121 | NY | Primary |
Addresses
Primary practice location
612 Walt Whitman Rd
Melville, NY 11747-2102
Mailing address
612 Walt Whitman Rd
Melville, NY 11747-2102
Phone (631) 629-4490
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
| License | State | Type | Specialty |
|---|---|---|---|
| 474121 | NY | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287532800000",
"number": "1790839637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 WALT WHITMAN RD",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117472102",
"telephone_number": "631-629-4490",
"fax_number": "631-629-4489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 WALT WHITMAN RD",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117472102",
"telephone_number": "631-629-4490",
"fax_number": "631-629-4489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUN",
"first_name": "E. MICHELLE",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2010-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "474121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.