Provider Demographics
NPI:1710936554
Name:NARAIN, KANAK L (DDS)
Entity Type:Individual
Prefix:DR
First Name:KANAK
Middle Name:L
Last Name:NARAIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 LOOP DR
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-1514
Mailing Address - Country:US
Mailing Address - Phone:631-563-4580
Mailing Address - Fax:
Practice Address - Street 1:155 E WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-1423
Practice Address - Country:US
Practice Address - Phone:631-758-6565
Practice Address - Fax:631-758-6568
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038278-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01202006Medicaid