KRISTEN BROCAVICH DDS NPI 1851901896

NPI Information

  • NPI: 1851901896
  • Provider Name: KRISTEN BROCAVICH, DDS
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Individual
  • Address: 150 ISLIP AVE STE 11
    ISLIP, NY
    ZIP 11751
  • Phone: (631) 581-3100

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NPI Details

Kristen Brocavich, DDS is a periodontics dentist in Islip, NY. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. Kristen Brocavich, DDS NPI is 1851901896. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

150 ISLIP AVE STE 11
ISLIP, NY
ZIP 11751-222
Phone: (631) 581-3100

The enumeration date for this NPI number is 8/4/2020 and was last updated on 8/4/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0300XDentistPeriodontics061138NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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