Provider Demographics
NPI:1033133608
Name:HINDIN, JEFFREY S (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:S
Last Name:HINDIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EXECUTIVE BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4164
Mailing Address - Country:US
Mailing Address - Phone:845-357-1595
Mailing Address - Fax:845-357-2428
Practice Address - Street 1:2 EXECUTIVE BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4164
Practice Address - Country:US
Practice Address - Phone:845-357-1595
Practice Address - Fax:845-357-2428
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0451471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY045147OtherSTATE DENTAL LICENSE