Active NPI
Kenneth Marc Gewant, D.M.D.
- Periodontics
- Plainview, NY
National Provider Identifier
1992707152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 036102
- Practice address
- 20 Bucknell Dr
Plainview, NY 11803-1802 - Phone
- (516) 376-5442
- NPI assigned
- Jun 1, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 036102 | NY | Primary |
Addresses
Primary practice location
20 Bucknell Dr
Plainview, NY 11803-1802
Mailing address
20 Bucknell Dr
Plainview, NY 11803-1802
Phone (516) 376-5442
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036102 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402012800000",
"number": "1992707152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 BUCKNELL DR",
"city": "PLAINVIEW",
"state": "NY",
"postal_code": "118031802",
"telephone_number": "516-376-5442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 BUCKNELL DR",
"city": "PLAINVIEW",
"state": "NY",
"postal_code": "118031802",
"telephone_number": "516-376-5442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEWANT",
"first_name": "KENNETH",
"middle_name": "MARC",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2014-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NY",
"license": "036102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainview, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.