Provider Demographics
NPI:1649402710
Name:KAHN, DONALD MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:MICHAEL
Last Name:KAHN
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 1:375 FULTON STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3454
Mailing Address - Country:US
Mailing Address - Phone:516-249-1188
Mailing Address - Fax:516-249-1194
Practice Address - Street 1:375 FULTON STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3454
Practice Address - Country:US
Practice Address - Phone:516-249-1188
Practice Address - Fax:516-249-1194
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist