Provider Demographics
NPI:1972715910
Name:SIEGEL, LINDA SHERYL (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:SHERYL
Last Name:SIEGEL
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 1:4743 LITTLE NECK PKWY
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1430
Mailing Address - Country:US
Mailing Address - Phone:718-224-4900
Mailing Address - Fax:718-224-9843
Practice Address - Street 1:4743 LITTLE NECK PKWY
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1430
Practice Address - Country:US
Practice Address - Phone:718-224-4900
Practice Address - Fax:718-224-9843
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042132-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice