Provider Demographics
NPI:1326509431
Name:DOBKIN, GABRIELA
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:DOBKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 VALENTINE ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2105
Mailing Address - Country:US
Mailing Address - Phone:908-331-1343
Mailing Address - Fax:
Practice Address - Street 1:191 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5024
Practice Address - Country:US
Practice Address - Phone:212-874-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062204-011223P0221X
390200000X
NJ22DI028819001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program