Provider Demographics
NPI:1871640771
Name:SCHWARTZ, ALAN JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JAY
Last Name:SCHWARTZ
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 1:7805 141ST ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3362
Mailing Address - Country:US
Mailing Address - Phone:718-380-1770
Mailing Address - Fax:718-380-7397
Practice Address - Street 1:7805 141ST ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3362
Practice Address - Country:US
Practice Address - Phone:718-380-1770
Practice Address - Fax:718-380-7397
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0397621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice