Kenneth Johannesen, DDS
NPI 1477507754 · Dentist · Northport, NY
Enrolled with Medicare as Order and Referring Only - Oral Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kenneth Johannesen, DDS is a Dentist provider in Northport, NY (NPI 1477507754).
Provider details
- NPI number
- 1477507754
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 044235 (NY)
Specialties & taxonomies
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-05-20
- Last updated
- 2007-07-12
Frequently asked questions
- What is Kenneth Johannesen's NPI number?
- Kenneth Johannesen's National Provider Identifier (NPI) is 1477507754, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kenneth Johannesen's specialty?
- Kenneth Johannesen is listed in the NPPES registry with a primary specialty of Dentist (Dental Providers).
- Where is Kenneth Johannesen located?
- Kenneth Johannesen's practice location on file with NPPES is 79 Middleville Rd, Northport, NY 11768-2200.
- What is Kenneth Johannesen's phone number?
- The practice phone number listed in the NPPES registry for Kenneth Johannesen is (631) 266-6057.
- Does Kenneth Johannesen accept Medicare?
- Kenneth Johannesen is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kenneth Johannesen's NPI active?
- Yes — Kenneth Johannesen's NPI (1477507754) is active in the NPPES registry as of the last update on 2007-07-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.