Provider Demographics
NPI:1477684876
Name:BACHMAN, JOEL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:A
Last Name:BACHMAN
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 1:2812 LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2229
Mailing Address - Country:US
Mailing Address - Phone:516-536-5340
Mailing Address - Fax:516-536-5383
Practice Address - Street 1:2812 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2229
Practice Address - Country:US
Practice Address - Phone:516-536-5340
Practice Address - Fax:516-536-5383
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0363751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00752621Medicaid