Provider Demographics
NPI:1578773354
Name:MAHONEY, MARGARET ELLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ELLEN
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4830 GLENWOOD STREET
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1423
Mailing Address - Country:US
Mailing Address - Phone:718-224-9370
Mailing Address - Fax:
Practice Address - Street 1:35 STARR STREET
Practice Address - Street 2:IS 347 349 DENTAL CLINIC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222
Practice Address - Country:US
Practice Address - Phone:718-418-6389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0354241122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist