Individual provider Active NPI

Desider Kohn, DMD

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1871768168
Registry record updated Jul 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
038510 Issued in NY
Practice address
5118 14TH Ave
Brooklyn, NY 11219-3638
Phone
(718) 436-2246
Fax
(718) 435-6855
NPI assigned
Apr 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 038510 NY Primary

Addresses

Primary practice location

5118 14TH Ave
Brooklyn, NY 11219-3638

Mailing address

5118 14TH Ave
Brooklyn, NY 11219-3638
Phone (718) 436-2246

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
I20160825001805 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3072808369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467417600000",
    "number": "1871768168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5118 14TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193638",
            "telephone_number": "718-436-2246",
            "fax_number": "718-435-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5118 14TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193638",
            "telephone_number": "718-436-2246",
            "fax_number": "718-435-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHN",
        "first_name": "DESIDER",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2016-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "038510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.