Provider Demographics
NPI:1205840774
Name:MILHIM, LEWIS G (DMD)
Entity Type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:G
Last Name:MILHIM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 ROGERS DR
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11724-1907
Mailing Address - Country:US
Mailing Address - Phone:516-680-4120
Mailing Address - Fax:
Practice Address - Street 1:240 CLINTON ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-2614
Practice Address - Country:US
Practice Address - Phone:516-481-2424
Practice Address - Fax:516-481-0208
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY346231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00412051Medicaid