Provider Demographics
NPI:1356682835
Name:WERBLIN, JEFFREY LYNNE (DMD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LYNNE
Last Name:WERBLIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 CORPORATE DR
Mailing Address - Street 2:APT 1814
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6621
Mailing Address - Country:US
Mailing Address - Phone:516-603-7272
Mailing Address - Fax:
Practice Address - Street 1:830 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-3433
Practice Address - Country:US
Practice Address - Phone:516-483-9628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27816122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist