Provider Demographics
NPI:1669511622
Name:SCHWARTZ, JEFFREY MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:SCHWARTZ
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 1:3601 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1375
Mailing Address - Country:US
Mailing Address - Phone:516-731-0200
Mailing Address - Fax:
Practice Address - Street 1:3601 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 125
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1375
Practice Address - Country:US
Practice Address - Phone:516-731-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36902122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist