Provider Demographics
NPI:1306840830
Name:WEISKOPF, LOUIS F (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:F
Last Name:WEISKOPF
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 1:108W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-3317
Mailing Address - Country:US
Mailing Address - Phone:516-431-8811
Mailing Address - Fax:516-431-8831
Practice Address - Street 1:108 W PARK AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-3317
Practice Address - Country:US
Practice Address - Phone:516-431-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0295991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice