Provider Demographics
NPI:1003044850
Name:PREMINGER, JOEL MICHAEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:MICHAEL
Last Name:PREMINGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 ELDERD LN
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2013
Mailing Address - Country:US
Mailing Address - Phone:516-239-1200
Mailing Address - Fax:516-324-3032
Practice Address - Street 1:87 ELDERD LN
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2013
Practice Address - Country:US
Practice Address - Phone:516-239-1200
Practice Address - Fax:516-324-3032
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP70907122300000X
NY0550501223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist