Provider Demographics
NPI:1134348410
Name:CIVELEK, KAYHAN (DDS MS)
Entity type:Individual
Prefix:
First Name:KAYHAN
Middle Name:
Last Name:CIVELEK
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CENTRAL PARK S
Mailing Address - Street 2:#209
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1436
Mailing Address - Country:US
Mailing Address - Phone:646-557-0317
Mailing Address - Fax:212-570-5034
Practice Address - Street 1:200 CENTRAL PARK S
Practice Address - Street 2:SUITE 209
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1436
Practice Address - Country:US
Practice Address - Phone:646-557-0317
Practice Address - Fax:212-570-5034
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY486171223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics