Provider Demographics
NPI:1568712669
Name:KERRIGAN, DANIEL TIMOTHY (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:TIMOTHY
Last Name:KERRIGAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 MAIN ST
Mailing Address - Street 2:#307
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-2772
Mailing Address - Country:US
Mailing Address - Phone:267-975-2978
Mailing Address - Fax:
Practice Address - Street 1:115 E 57TH ST STE 1470
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2107
Practice Address - Country:US
Practice Address - Phone:212-371-8181
Practice Address - Fax:212-371-8212
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-16
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057872122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist