DR. KENNETH PAUL DOALTOWSKI (NPI# 1598967440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598967440 |
| Entity Type | Individual |
| Full Name | DR. KENNETH PAUL DOALTOWSKI |
| Credential | DDS, MS |
| Practice Address |
2105 W Genesee St Suite 207 Syracuse NY 13219-1656 |
| Mailing Address |
509 Emann Dr Camillus NY 13031-3011 |
| Practice Telephone | 3154680031 |
| Practice Fax Number | 3154873599 |
| Mailing Telephone | 3154871270 |
| Mailing Fax Number | 3154873599 |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
032859-1 | NY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00447374 | 05 |
| Street Address |
2105 W GENESEE ST SUITE 207 |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13219-1656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902888142 | Peter W Calabrese | Podiatrist | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2005-11-15 |
| 1104360536 | Karen Gana | Acupuncturist | 2105 W Genesee St, Suite 209, Syracuse, NY 13219-1656 | 2016-12-03 |
| 1245605997 | Dr. P. Teluk, Dds, PC | Clinic/Center | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2015-12-07 |
| 1073981254 | Joeann Haste-bentley | Licensed Practical Nurse | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2015-09-04 |
| 1720469687 | Ashley Marie Vega | Registered Nurse | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2015-06-16 |
| 1104230317 | Martha Mary Kicak | Licensed Practical Nurse | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2014-06-16 |
| 1891127254 | Joan W Diehl | Registered Nurse | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2013-08-07 |
| 1487090585 | Susan M Hanlon | Registered Nurse | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2013-05-15 |
| 1225377229 | Dianna C Torrisi | Licensed Practical Nurse | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2013-02-11 |
| 1891032777 | Heather Lynn Longo | Licensed Practical Nurse | 2105 W Genesee St, Syracuse, NY 13219-1698 | 2013-01-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972155125 | Claire A Conroy | Registered Nurse | Westhill High School, 4501 Onondaga Blvd, Syracuse, NY 13219 | 2019-07-09 |
| 1699339242 | Gia Ruffini | Licensed Practical Nurse | 212 South Terry Rd., Syracuse, NY 13219 | 2019-04-30 |
| 1629549373 | Amy Elisabeth Steigerwald | Registered Nurse | 400 Walberta Rd., Syracuse, NY 13219 | 2018-12-06 |
| 1073007670 | Bryan D. O'neil | Optometrist | 4109 W Genesee St Ste 100, Syracuse, NY 13219 | 2018-06-18 |
| 1801279732 | Podiatry Services of Central New York, PC | Podiatrist | 4623 Onondaga Blvd., Syracuse, NY 13219 | 2015-07-09 |
| 1699118893 | Christine Anne Marshall | Licensed Practical Nurse | 1604 West High Terrace, Syracuse, NY 13219 | 2013-04-08 |
| 1447596515 | Mary Lou Karrat | Social Worker | 4336 Fay Road, Syracuse, NY 13219 | 2012-12-18 |
| 1801193636 | America's Best Contacts & Eyeglasses | Technician/Technologist | 3439 W. Genesee St., Ste. 300, Syracuse, NY 13219 | 2011-02-14 |
| 1053616904 | Ranz Consulting Goup | Preferred Provider Organization | 104 Watchower Ln, Syracuse, NY 13219 | 2011-01-24 |
| 1003123480 | Lisa Marie Searles | Occupational Therapist | 110 Elmtree Lane, Syracuse, NY 13219 | 2010-09-08 |
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| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881108983 | Nathan Fowler | Dentist | 3469 Erie Blvd E # 3a, Syracuse, NY 13214 | 2017-11-28 |
| 1326104423 | Michael P Meharg | Dentist | 526 Plum St, Suite 100, Syracuse, NY 13204-1495 | 2006-12-31 |
| 1427111558 | Sheldon L Peck | Dentist | 1747 S Heritage Lane, Suite A3, Syracuse, UT 84075 | 2006-12-19 |
| 1235247438 | Brett R Coleman | Dentist | 780 S 2000 W, Bldg E304, Syracuse, UT 84075 | 2006-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616356 | Nathan Light | Dentist | M Dental Care PC, 337 Lenox Ave, New York, NY 10027 | 2020-10-09 |
| 1467069575 | Thomas P. Shannon, Dds, Professional Corporation | Dentist | 44 W 28th St Fl 14, New York, NY 10001-4212 | 2020-09-23 |
| 1508471665 | Daniella Davis | Dentist | 500 Portion Rd Ste 15, Lake Ronkonkoma, NY 11779-4587 | 2020-09-14 |
| 1144835927 | Nikhil Narkhede | Dentist | 401 Columbus Ave Ste 100, Valhalla, NY 10595-1349 | 2020-09-09 |
| 1619580040 | Amanda Beth Albin | Dentist | 62 Lake Ave S Ste A, Nesconset, NY 11767-1094 | 2020-08-25 |
| 1770109589 | Empire State Orthodontics, P.C. | Dentist | 2840 Military Rd, Niagara Falls, NY 14304-1566 | 2020-06-18 |
| 1457986044 | Todd Weinberger | Dentist | 1097 Old Country Rd Ste 203, Plainview, NY 11803-6505 | 2020-03-04 |
| 1851926513 | Miang Chneh C Teo | Dentist | 1100 Pelham Pkwy S, Bronx, NY 10461-1001 | 2020-03-03 |
| 1871127209 | Parisa Zare | Dentist | 40 Waterside Plz Apt 23e, New York, NY 10010-2633 | 2020-02-25 |
| 1427680776 | Sfc Orthodontics P.C. | Dentist | 738 58th St., 1st Floor, Brooklyn, NY 11220 | 2020-02-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.