Provider Demographics
NPI:1114530284
Name:PAVLUSHKIN, STEVEN EMANUEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:EMANUEL
Last Name:PAVLUSHKIN
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 1:55 BUCKLEY RD
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-2108
Mailing Address - Country:US
Mailing Address - Phone:732-690-0794
Mailing Address - Fax:
Practice Address - Street 1:922 ROUTE 35
Practice Address - Street 2:
Practice Address - City:OCEAN TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07712
Practice Address - Country:US
Practice Address - Phone:848-217-2029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL253721223G0001X
SCDGD.97291223G0001X
NJ22DI029442011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice