Provider Demographics
NPI:1902068844
Name:KACI, KASTRIOT (GENERAL DENTIST)
Entity type:Individual
Prefix:DR
First Name:KASTRIOT
Middle Name:
Last Name:KACI
Suffix:
Gender:M
Credentials:GENERAL DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HILLBURN RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-2719
Mailing Address - Country:US
Mailing Address - Phone:352-246-3458
Mailing Address - Fax:
Practice Address - Street 1:2176 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-1826
Practice Address - Country:US
Practice Address - Phone:914-337-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056431-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice