Krisda Tom Hemintakoon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

045566 Issued in NY

Practice address

13705 Franklin Ave Ste L1
Flushing, NY 11355-3801

Phone

(718) 321-9870

NPI assigned

Dec 15, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1841529211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 DANEBURY DOWNS",
            "city": "UPPER SADDLE RIVER",
            "state": "NJ",
            "postal_code": "074581507",
            "telephone_number": "718-321-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13705 FRANKLIN AVE STE L1",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553801",
            "telephone_number": "718-321-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMINTAKOON",
        "first_name": "KRISDA",
        "middle_name": "TOM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-15",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045566",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02198400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Flushing, NY
• Providers in Flushing, 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 Dec 15, 2009; 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.