Provider Demographics
NPI:1720342959
Name:TEMKIN, ROMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROMAN
Middle Name:
Last Name:TEMKIN
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 1:127 E MAIN ST STE 131
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-5118
Mailing Address - Country:US
Mailing Address - Phone:458-342-5866
Mailing Address - Fax:
Practice Address - Street 1:127 E MAIN ST STE 131
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-5118
Practice Address - Country:US
Practice Address - Phone:845-342-5866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0590291223S0112X
FLDN255551223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery