Provider Demographics
NPI:1265808331
Name:BUCHANAN DENTAL ARTS PLLC
Entity type:Organization
Organization Name:BUCHANAN DENTAL ARTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOVITCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-737-6300
Mailing Address - Street 1:107 BANNON AVE
Mailing Address - Street 2:
Mailing Address - City:BUCHANAN
Mailing Address - State:NY
Mailing Address - Zip Code:10511-1301
Mailing Address - Country:US
Mailing Address - Phone:914-737-6300
Mailing Address - Fax:914-737-6302
Practice Address - Street 1:107 BANNON AVE
Practice Address - Street 2:
Practice Address - City:BUCHANAN
Practice Address - State:NY
Practice Address - Zip Code:10511-1301
Practice Address - Country:US
Practice Address - Phone:914-737-6300
Practice Address - Fax:914-737-6302
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUCHANAN DENTAL ARTS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-12
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty