Provider Demographics
NPI:1659390052
Name:POKORNY, MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:POKORNY
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 1:1 WESTGATE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2428
Mailing Address - Country:US
Mailing Address - Phone:516-488-2570
Mailing Address - Fax:516-352-5831
Practice Address - Street 1:1 WESTGATE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2428
Practice Address - Country:US
Practice Address - Phone:516-488-2570
Practice Address - Fax:516-352-5831
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0276951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice