Provider Demographics
NPI:1437132784
Name:FIKHMAN, MIKHAIL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MIKHAIL
Middle Name:
Last Name:FIKHMAN
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 1:457 KINGS HWY
Mailing Address - Street 2:BROOKLYN
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:11223
Mailing Address - Country:US
Mailing Address - Phone:718-382-5005
Mailing Address - Fax:718-382-6963
Practice Address - Street 1:457 KINGS HWY
Practice Address - Street 2:BROOKLYN
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11223
Practice Address - Country:US
Practice Address - Phone:718-382-5005
Practice Address - Fax:718-382-6963
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0449591122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01435212Medicare ID - Type Unspecified