Joseph R Klochak, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

008337 Issued in VA

Practice address

2240 Coliseum Dr Ste C
Hampton, VA 23666-5903

Phone

(757) 826-1121

Fax

(757) 826-1155

NPI assigned

Oct 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 24, 2016 through Feb 24, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shayegh and Khanna DDS PLLC

  • General Practice Dentistry
  • Hampton, VA
  • NPI 1972254902
  NPD (past)

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

{
    "created_epoch": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841373354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 HUNTS NECK RD",
            "city": "POQUOSON",
            "state": "VA",
            "postal_code": "236621016",
            "telephone_number": "757-868-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 COLISEUM DR STE C",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665903",
            "telephone_number": "757-826-1121",
            "fax_number": "757-826-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOCHAK",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "008337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Jean Kistner, FNP-BC
• KL Gash & Associates LLC
• Frank Edward Parry Klages IV, LCSW
• KLG Counseling & Consulting Services, LLC
• Travis Kling, MD
• Shannon Kluttz, PA-C
• Matthew Knaub
• Helena Kneaul
• Ekiya Alexis Knight
• David J Kobulnicky, MD

• General Practice Dentistry in Hampton, VA
• Providers in Hampton, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.