Provider Demographics
NPI:1962583492
Name:DR KENNETH HALPERN
Entity type:Organization
Organization Name:DR KENNETH HALPERN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:LONDON
Authorized Official - Last Name:HALPERN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:516-621-2323
Mailing Address - Street 1:70 GLEN COVE ROAD
Mailing Address - Street 2:SUITE 304
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 304
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery