Provider Demographics
NPI:1821219692
Name:JOSEN, TANNY (DDS)
Entity Type:Individual
Prefix:DR
First Name:TANNY
Middle Name:
Last Name:JOSEN
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 1:400 SOUTH OYSTER BAY RD.
Mailing Address - Street 2:MID-ISLAND DENTAL ASSOCIATES
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801
Mailing Address - Country:US
Mailing Address - Phone:516-933-8600
Mailing Address - Fax:516-942-3585
Practice Address - Street 1:400 SOUTH OYSTER BAY RD.
Practice Address - Street 2:MID-ISLAND DENTAL ASSOCIATES
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801
Practice Address - Country:US
Practice Address - Phone:516-933-8600
Practice Address - Fax:516-942-3585
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0472571223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry