Provider Demographics
NPI:1649345737
Name:VEY VODA, DENISE MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:MARIE
Last Name:VEY VODA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 SOUTH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-2251
Mailing Address - Country:US
Mailing Address - Phone:516-922-5730
Mailing Address - Fax:516-922-5762
Practice Address - Street 1:123 SOUTH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-2251
Practice Address - Country:US
Practice Address - Phone:516-922-5730
Practice Address - Fax:516-922-5762
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0367591223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD8F671Medicare ID - Type UnspecifiedMEDICARE NUMBER