Provider Demographics
NPI:1295862571
Name:ALBANESE, JAMES RANDALL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RANDALL
Last Name:ALBANESE
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 1:33 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7154
Mailing Address - Country:US
Mailing Address - Phone:631-254-3349
Mailing Address - Fax:
Practice Address - Street 1:3000 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 101
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1381
Practice Address - Country:US
Practice Address - Phone:516-735-3535
Practice Address - Fax:516-735-7297
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046960-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice