Provider Demographics
NPI:1851434914
Name:STRICKMAN, KENT DOUGLAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:DOUGLAS
Last Name:STRICKMAN
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 1:5800 3RD AVE
Mailing Address - Street 2:MANAGED CARE DEPARTMENT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3702
Mailing Address - Country:US
Mailing Address - Phone:718-630-7477
Mailing Address - Fax:718-630-7437
Practice Address - Street 1:150 55TH ST
Practice Address - Street 2:LUTHERAN FHC DENTAL CLINIC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2559
Practice Address - Country:US
Practice Address - Phone:718-630-7152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0487251223G0001X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice