Provider Demographics
NPI:1801878285
Name:A-Z DENTAL PC
Entity type:Organization
Organization Name:A-Z DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEKHTMEYSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-832-1222
Mailing Address - Street 1:332 9TH ST
Mailing Address - Street 2:2ND FLOOR, APT. 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4058
Mailing Address - Country:US
Mailing Address - Phone:718-832-1222
Mailing Address - Fax:718-832-0796
Practice Address - Street 1:332 9TH ST
Practice Address - Street 2:2ND FLOOR, APT. 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4058
Practice Address - Country:US
Practice Address - Phone:718-832-1222
Practice Address - Fax:718-832-0796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-19
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0441911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty