Provider Demographics
NPI:1881226686
Name:ROCKVILLE ENDODONTICS, PC
Entity Type:Organization
Organization Name:ROCKVILLE ENDODONTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST/EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEMANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-415-2972
Mailing Address - Street 1:371 MERRICK RD STE 205
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5301
Mailing Address - Country:US
Mailing Address - Phone:516-415-2972
Mailing Address - Fax:516-766-6066
Practice Address - Street 1:371 MERRICK RD STE 205
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5301
Practice Address - Country:US
Practice Address - Phone:516-415-2972
Practice Address - Fax:516-766-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty