Provider Demographics
NPI:1295862258
Name:STARKMAN, DAVID T (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:T
Last Name:STARKMAN
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:PO BOX 788
Mailing Address - Street 2:
Mailing Address - City:VALATIE
Mailing Address - State:NY
Mailing Address - Zip Code:12184-0788
Mailing Address - Country:US
Mailing Address - Phone:518-758-7179
Mailing Address - Fax:518-758-1579
Practice Address - Street 1:2870 ROUTE 9
Practice Address - Street 2:
Practice Address - City:VALATIE
Practice Address - State:NY
Practice Address - Zip Code:12184
Practice Address - Country:US
Practice Address - Phone:518-758-7179
Practice Address - Fax:518-758-1579
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0371421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY141657880OtherTAX ID
NY6531680001Medicare NSC