Kimberly Kerry Justus-Tauer, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

048183 Issued in NY

Practice address

61 Nassau Ave
Islip, NY 11751-3607

Phone

(631) 277-5099

Fax

(631) 581-0635

NPI assigned

Nov 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1801962139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MEEKS LN",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513706",
            "telephone_number": "631-224-1623",
            "fax_number": "631-581-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 NASSAU AVE",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513607",
            "telephone_number": "631-277-5099",
            "fax_number": "631-581-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTUS-TAUER",
        "first_name": "KIMBERLY",
        "middle_name": "KERRY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02120327",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cindy Laura Jadoo, MD
• Kelly Anne Jewels
• Devendra P Jhamb
• Shashi B Jhamb, M.D.
• Suni Benny Joseph
• Kenneth Charles Kalman, DC
• Sarah Kappus, MD
• Kathleen M. Frost, DDS PC
• Alissa Kavun, LPN
• Heather Lynnn Keach

• General Practice Dentistry in Islip, NY
• Providers in Islip, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.