Provider Demographics
NPI:1134426505
Name:INGBER, ALAN S (DDS)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:S
Last Name:INGBER
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 1:780 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:SI
Mailing Address - State:NY
Mailing Address - Zip Code:10310
Mailing Address - Country:US
Mailing Address - Phone:718-442-3482
Mailing Address - Fax:718-442-3485
Practice Address - Street 1:780 FOREST AVE
Practice Address - Street 2:
Practice Address - City:SI
Practice Address - State:NY
Practice Address - Zip Code:10310
Practice Address - Country:US
Practice Address - Phone:718-442-3482
Practice Address - Fax:718-442-3485
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0346531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice