Provider Demographics
NPI:1891730362
Name:PANEV, ANGUEL HRISTOV (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGUEL
Middle Name:HRISTOV
Last Name:PANEV
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 1:1137 86TH ST
Mailing Address - Street 2:2 FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3320
Mailing Address - Country:US
Mailing Address - Phone:718-680-2670
Mailing Address - Fax:
Practice Address - Street 1:772 GRAND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-5395
Practice Address - Country:US
Practice Address - Phone:718-218-9494
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-18
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0507011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02530032Medicaid