Provider Demographics
NPI:1750384756
Name:REIN, JEFFREY S (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:S
Last Name:REIN
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 1:101 HILLSIDE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-2310
Mailing Address - Country:US
Mailing Address - Phone:516-741-6202
Mailing Address - Fax:516-741-9620
Practice Address - Street 1:101 HILLSIDE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-2310
Practice Address - Country:US
Practice Address - Phone:516-741-6202
Practice Address - Fax:516-741-9620
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0367191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6398710001Medicare NSC