Provider Demographics
NPI:1245726082
Name:RANDI, WILLIAM A (DDS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:RANDI
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 1:423 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5011
Mailing Address - Country:US
Mailing Address - Phone:212-686-7500
Mailing Address - Fax:
Practice Address - Street 1:262 S RIVER RD STE 102
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6916
Practice Address - Country:US
Practice Address - Phone:603-625-6456
Practice Address - Fax:603-627-6556
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH047551223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics