Provider Demographics
NPI:1346418126
Name:CARRION, HILSHA (DMD)
Entity Type:Individual
Prefix:DR
First Name:HILSHA
Middle Name:
Last Name:CARRION
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-2223
Mailing Address - Country:US
Mailing Address - Phone:631-473-0582
Mailing Address - Fax:631-473-3525
Practice Address - Street 1:714 MAIN ST
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2223
Practice Address - Country:US
Practice Address - Phone:631-473-0582
Practice Address - Fax:631-473-3525
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052383-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist