Provider Demographics
NPI:1932100310
Name:GINDI, EDDY (DMD)
Entity Type:Individual
Prefix:
First Name:EDDY
Middle Name:
Last Name:GINDI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 KINGS HWY
Mailing Address - Street 2:1E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1449
Mailing Address - Country:US
Mailing Address - Phone:718-375-2020
Mailing Address - Fax:718-375-1925
Practice Address - Street 1:2020 KINGS HWY
Practice Address - Street 2:1E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1449
Practice Address - Country:US
Practice Address - Phone:718-375-2020
Practice Address - Fax:718-375-1925
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0309921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00297641Medicaid