Provider Demographics
NPI:1750598082
Name:ZANDMAN, IRWIN (DDS)
Entity type:Individual
Prefix:
First Name:IRWIN
Middle Name:
Last Name:ZANDMAN
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 1:1995 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1995 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3603
Practice Address - Country:US
Practice Address - Phone:212-427-2636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2013-02-14
Deactivation Date:2013-02-08
Deactivation Code:
Reactivation Date:2013-02-14
Provider Licenses
StateLicense IDTaxonomies
NY0294291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice