Individual provider Active NPI

Robert Morris Knepper, D.D.S.

  • Periodontics
  • Great Neck, NY
National Provider Identifier
1851372791
Registry record updated Mar 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
030859 Issued in NY
Practice address
1 Kensington Gate Apt 214
Great Neck, NY 11021-1229
Phone
(516) 297-1227
Fax
(516) 829-5450
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 030859 NY Primary

Addresses

Primary practice location

1 Kensington Gate Apt 214
Great Neck, NY 11021-1229

Mailing address

1 Kensington Gate Apt 214
Great Neck, NY 11021-1229
Phone (516) 297-1227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150525000003 NY Order and Referring Only - DentistPractitioner - Dentist 8224358718

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030859NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Astoria Dental LLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711238400000",
    "number": "1851372791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KENSINGTON GATE APT 214",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211229",
            "telephone_number": "516-297-1227",
            "fax_number": "516-829-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KENSINGTON GATE APT 214",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211229",
            "telephone_number": "516-297-1227",
            "fax_number": "516-829-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNEPPER",
        "first_name": "ROBERT",
        "middle_name": "MORRIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2024-03-24",
        "certification_date": "2024-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "030859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.