Individual provider Active NPI

Brian S. Klohn, DMD

  • Dentist
  • Lakehurst, NJ
National Provider Identifier
1841430618
Registry record updated Mar 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DIO17801 Issued in NJ
Practice address
19 Union Ave
Lakehurst, NJ 08733-3023
Phone
(732) 657-7400
Fax
(732) 657-2200
NPI assigned
Mar 5, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DIO17801 NJ Primary

Addresses

Primary practice location

19 Union Ave
Lakehurst, NJ 08733-3023

Mailing address

19 Union Ave
Lakehurst, NJ 08733-3023
Phone (732) 657-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20150915001198 NJ Order and Referring Only - DentistPractitioner - Dentist 9032426630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DIO17801NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236211200000",
    "number": "1841430618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 UNION AVE",
            "city": "LAKEHURST",
            "state": "NJ",
            "postal_code": "087333023",
            "telephone_number": "732-657-7400",
            "fax_number": "732-657-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 UNION AVE",
            "city": "LAKEHURST",
            "state": "NJ",
            "postal_code": "087333023",
            "telephone_number": "732-657-7400",
            "fax_number": "732-657-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOHN",
        "first_name": "BRIAN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-05",
        "last_updated": "2009-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DIO17801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakehurst, NJ

Sources for this page

Verify at the official NPI Registry.