Provider Demographics
NPI:1184657546
Name:PODLINSKI, DOROTA (DDS)
Entity Type:Individual
Prefix:
First Name:DOROTA
Middle Name:
Last Name:PODLINSKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CLUB HOUSE CT
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-2813
Mailing Address - Country:US
Mailing Address - Phone:516-937-0061
Mailing Address - Fax:212-358-1747
Practice Address - Street 1:530 GRAND ST # D
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-4258
Practice Address - Country:US
Practice Address - Phone:212-475-8170
Practice Address - Fax:212-358-1747
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0404881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice