Provider Demographics
NPI:1477556462
Name:KIRSCHNER, HOWARD JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:JAY
Last Name:KIRSCHNER
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 1:338 BEACH 54TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1782
Mailing Address - Country:US
Mailing Address - Phone:718-634-2123
Mailing Address - Fax:718-544-0166
Practice Address - Street 1:338 BEACH 54TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11692-1782
Practice Address - Country:US
Practice Address - Phone:718-634-2123
Practice Address - Fax:718-544-0166
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-22
Provider Licenses
StateLicense IDTaxonomies
NY232491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice