Provider Demographics
NPI:1184972283
Name:ZOLDAN, BILLIE R (DDS)
Entity type:Individual
Prefix:DR
First Name:BILLIE
Middle Name:R
Last Name:ZOLDAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:BILLIE
Other - Middle Name:R
Other - Last Name:GOLDWYN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:393 W END AVE
Mailing Address - Street 2:APT 10C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6138
Mailing Address - Country:US
Mailing Address - Phone:516-297-4794
Mailing Address - Fax:
Practice Address - Street 1:393 W END AVE
Practice Address - Street 2:APT 10C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6138
Practice Address - Country:US
Practice Address - Phone:516-297-4794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05632111223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics