Provider Demographics
NPI:1598090011
Name:HOWARD JAY KIRSCHNER,DDS, PLLC
Entity Type:Organization
Organization Name:HOWARD JAY KIRSCHNER,DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:KIRSCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-634-2123
Mailing Address - Street 1:338 BEACH 54TH STREET
Mailing Address - Street 2:BEACH 54TH ST DENTAL BUILDING
Mailing Address - City:FAR ROCKAWAY-ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1782
Mailing Address - Country:US
Mailing Address - Phone:718-634-2123
Mailing Address - Fax:718-634-2125
Practice Address - Street 1:338 BEACH 54TH ST
Practice Address - Street 2:BEACH 54TH ST DENTAL BUILDING
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11692-1782
Practice Address - Country:US
Practice Address - Phone:718-634-2123
Practice Address - Fax:718-634-2125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0232491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty