Provider Demographics
NPI:1164643722
Name:MUSHEYEV, NATALYA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATALYA
Middle Name:
Last Name:MUSHEYEV
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:MUSHEYEV
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:81-14 BAXTER AVE
Mailing Address - Street 2:81-14 BAXTER AVE
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373
Mailing Address - Country:US
Mailing Address - Phone:718-424-4884
Mailing Address - Fax:718-424-4777
Practice Address - Street 1:81-14 BAXTER AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-424-4884
Practice Address - Fax:718-424-4777
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048711-01122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist