Provider Demographics
NPI:1396185773
Name:BIERVLIET-SCHRANZ, GRAEME (DDS)
Entity Type:Individual
Prefix:DR
First Name:GRAEME
Middle Name:
Last Name:BIERVLIET-SCHRANZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:GRAEME
Other - Middle Name:
Other - Last Name:SCHRANZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:585 SCHENECTADY AVE
Mailing Address - Street 2:DENTAL DEPARTMENT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1892
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:585 SCHENECTADY AVE
Practice Address - Street 2:DENTAL DEPARTMENT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1892
Practice Address - Country:US
Practice Address - Phone:718-604-5381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0573371223G0001X
NJ22DI025805001223G0001X
CT115491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04140676Medicaid