Provider Demographics
NPI:1790988210
Name:NAYLOR, VIVIENNE MARION (DDS)
Entity Type:Individual
Prefix:DR
First Name:VIVIENNE
Middle Name:MARION
Last Name:NAYLOR
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 1:6 MAPLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-1018
Mailing Address - Country:US
Mailing Address - Phone:516-676-7835
Mailing Address - Fax:
Practice Address - Street 1:101 AVENUE OF THE AMERICAS
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-1933
Practice Address - Country:US
Practice Address - Phone:212-734-5664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042606-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist