Provider Demographics
NPI:1346707916
Name:5D DENTAL PLLC
Entity Type:Organization
Organization Name:5D DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MNGR
Authorized Official - Prefix:
Authorized Official - First Name:MARKUS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-457-3111
Mailing Address - Street 1:150 IRVING PLACE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598
Mailing Address - Country:US
Mailing Address - Phone:516-374-9100
Mailing Address - Fax:
Practice Address - Street 1:150 IRVING PLACE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598
Practice Address - Country:US
Practice Address - Phone:516-374-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty