Provider Demographics
NPI:1386642676
Name:EHRLICH, IRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:
Last Name:EHRLICH
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 1:509 W MERRICK RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5236
Mailing Address - Country:US
Mailing Address - Phone:516-568-0310
Mailing Address - Fax:
Practice Address - Street 1:509 W MERRICK RD
Practice Address - Street 2:SUITE 103
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5236
Practice Address - Country:US
Practice Address - Phone:516-568-0310
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0343021223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics