Provider Demographics
NPI:1528403813
Name:RIFKIN DENTAL CARMEL, PLLC
Entity Type:Organization
Organization Name:RIFKIN DENTAL CARMEL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RIFKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-306-7941
Mailing Address - Street 1:1071 STONELEIGH AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-2400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1071 STONELEIGH AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2400
Practice Address - Country:US
Practice Address - Phone:845-306-7941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039409122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty