Provider Demographics
NPI:1558529156
Name:NEWMAN, IRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:
Last Name:NEWMAN
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 1:1044 NORTHERN BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1514
Mailing Address - Country:US
Mailing Address - Phone:516-625-0088
Mailing Address - Fax:516-625-0008
Practice Address - Street 1:1044 NORTHERN BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1514
Practice Address - Country:US
Practice Address - Phone:516-625-0088
Practice Address - Fax:516-625-0008
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042246122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist