Provider Demographics
NPI:1710266721
Name:SALKIN, MICHAEL BRETT (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRETT
Last Name:SALKIN
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 1:236 LIVINGSTON ST
Mailing Address - Street 2:5D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5812
Mailing Address - Country:US
Mailing Address - Phone:917-992-6883
Mailing Address - Fax:
Practice Address - Street 1:3029 AVENUE V
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5448
Practice Address - Country:US
Practice Address - Phone:718-332-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055702122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY055702OtherNY STATE DENTAL LICENSE