Provider Demographics
NPI:1467527572
Name:KAMEN, JONATHAN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:M
Last Name:KAMEN
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 1:45 WALWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1431
Mailing Address - Country:US
Mailing Address - Phone:914-262-1398
Mailing Address - Fax:914-725-1442
Practice Address - Street 1:45 WALWORTH AVE
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1431
Practice Address - Country:US
Practice Address - Phone:914-262-1398
Practice Address - Fax:212-677-1907
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0296331223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics