Provider Demographics
NPI:1184843062
Name:GOLOMBECK, IRVING (DDS)
Entity Type:Individual
Prefix:DR
First Name:IRVING
Middle Name:
Last Name:GOLOMBECK
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 1:24 ARLEIGH RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1338
Mailing Address - Country:US
Mailing Address - Phone:516-487-0314
Mailing Address - Fax:
Practice Address - Street 1:24 ARLEIGH RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1338
Practice Address - Country:US
Practice Address - Phone:516-487-0314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0301681223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics