Provider Demographics
NPI:1891851234
Name:TITUNIK, IRA R (DDS)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:R
Last Name:TITUNIK
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 1:121 E 69TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5004
Mailing Address - Country:US
Mailing Address - Phone:212-650-0035
Mailing Address - Fax:212-650-0038
Practice Address - Street 1:121 E 69TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5004
Practice Address - Country:US
Practice Address - Phone:212-650-0035
Practice Address - Fax:212-650-0038
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice