Provider Demographics
NPI:1942415419
Name:HONIKMAN, SHOSHANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHOSHANA
Middle Name:
Last Name:HONIKMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 W END AVE APT 7F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6146
Mailing Address - Country:US
Mailing Address - Phone:516-270-6103
Mailing Address - Fax:
Practice Address - Street 1:765 UNITED NATIONS PLZ
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-3501
Practice Address - Country:US
Practice Address - Phone:516-270-6103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047954 1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02313528Medicaid