Provider Demographics
NPI:1952694101
Name:FAIGEN, SETH M (DMD)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:M
Last Name:FAIGEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11614 METROPOLITAN AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1017
Mailing Address - Country:US
Mailing Address - Phone:718-849-9472
Mailing Address - Fax:
Practice Address - Street 1:11614 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1017
Practice Address - Country:US
Practice Address - Phone:718-849-9472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-20
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056250-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist