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MISS KENDRA MARIE IRIZARRY PAGAN DMD
NPI 1427491786
Dentist - Oral and Maxillofacial Surgery in New York, NY

Active since April 16, 2013Opted out of Medicare · through Sep 30, 2026
200 W 57TH ST STE 804, NEW YORK, NY 10019(646) 895-9680(646) 895-9679 Get Directions Write a Review

NPPES record last updated: November 12, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 12, 2025, Jan 24, 2023, Aug 24, 2022 (3 updates tracked since 2022).

About Miss Kendra Marie Irizarry Pagan Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS KENDRA MARIE IRIZARRY PAGAN DMD (NPI 1427491786) is an individual oral and maxillofacial surgery provider in New York, New York, licensed in New York (057502-01) and active in the NPI registry since April 2013. She has opted out of Medicare through September 30, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1427491786
Entity TypeIndividualFemale
Primary Taxonomy1223S0112X
Provider Legal NameMISS KENDRA MARIE IRIZARRY PAGANCredential: DMD
Location Address200 W 57TH ST STE 804New York, NY 10019-3266
Mailing Address108 E 96th St Apt 18bNew York, NY 10128-6222 · (917) 705-2383
Phone(646) 895-9680
Fax(646) 895-9679
Sole ProprietorYes
Enumeration DateApril 16, 2013
Last NPPES UpdateNovember 12, 20253 updates tracked since enumeration
NPPES CertifiedNovember 12, 2025
✔ NPI 1427491786 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in NY · 057502-01
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
200 W 57TH ST STE 804, New York, NY 10019
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Miss Kendra Marie Irizarry Pagan Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 30, 2022 through September 30, 2026.

Opt-Out Effective DateSeptember 30, 2022
Opt-Out In Effect ThroughSeptember 30, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10019 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUSTIN RIECE FAZZOLARI DMD, MD
Dentist (Oral and Maxillofacial Surgery)
200 W 57TH ST STE 804
NEW YORK, NY 10019
New York County (646) 895-9680

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kendra Irizarry Pagan's NPI number?

The NPI number for Kendra Irizarry Pagan is 1427491786. It was assigned to this individual provider in the NPPES registry on April 16, 2013.

Where is Kendra Irizarry Pagan located?

Kendra Irizarry Pagan practices at 200 W 57th St Ste 804, New York, NY 10019. The listed phone number is (646) 895-9680.

What is Kendra Irizarry Pagan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Kendra Irizarry Pagan enrolled in Medicare?

No. Kendra Irizarry Pagan has opted out of Medicare through September 30, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Kendra Irizarry Pagan accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Humana and UnitedHealthcare list Kendra Irizarry Pagan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kendra Irizarry Pagan was last updated on November 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.