Provider Demographics
NPI:1205914439
Name:HALPERN, KENNETH LONDON (DDS MS)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:LONDON
Last Name:HALPERN
Suffix:
Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:70 GLEN COVE ROAD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577
Mailing Address - Country:US
Mailing Address - Phone:516-621-2323
Mailing Address - Fax:516-484-8854
Practice Address - Street 1:70 GLEN COVE ROAD
Practice Address - Street 2:SUITE 206
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577
Practice Address - Country:US
Practice Address - Phone:516-621-2323
Practice Address - Fax:516-484-8854
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY325621223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
D9B852Medicare ID - Type Unspecified
J89830Medicare UPIN