Provider Demographics
NPI:1871676114
Name:ARNOLDT, ADAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:ARNOLDT
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 1:105 S BEDFORD RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3441
Mailing Address - Country:US
Mailing Address - Phone:914-242-1142
Mailing Address - Fax:914-242-1147
Practice Address - Street 1:105 S BEDFORD RD
Practice Address - Street 2:SUITE 330
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3441
Practice Address - Country:US
Practice Address - Phone:914-242-1142
Practice Address - Fax:914-242-1147
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0497111223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02409378Medicaid