Provider Demographics
NPI:1386860401
Name:HE, THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:HE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:ZHEN MING
Other - Middle Name:
Other - Last Name:HE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4279 78TH ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2953
Mailing Address - Country:US
Mailing Address - Phone:718-651-2768
Mailing Address - Fax:
Practice Address - Street 1:612 60TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4101
Practice Address - Country:US
Practice Address - Phone:718-567-8283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0529061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice