Provider Demographics
NPI:1740532456
Name:ABIKHZER, JOEL (DMD, MSC)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:
Last Name:ABIKHZER
Suffix:
Gender:M
Credentials:DMD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 W BAY PLZ
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1787
Mailing Address - Country:US
Mailing Address - Phone:518-825-0025
Mailing Address - Fax:518-825-0029
Practice Address - Street 1:304 W BAY PLZ
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1787
Practice Address - Country:US
Practice Address - Phone:518-825-0025
Practice Address - Fax:518-825-0029
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056427-11223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery