Provider Demographics
NPI:1215196951
Name:INSARDI, ANDREW R (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:R
Last Name:INSARDI
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 1:6035 69TH ST
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-2930
Mailing Address - Country:US
Mailing Address - Phone:718-478-0201
Mailing Address - Fax:
Practice Address - Street 1:6035 69TH ST
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-2930
Practice Address - Country:US
Practice Address - Phone:718-478-0201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-07
Last Update Date:2008-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0348361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice