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NPI Code Detail

MEDICARE: CONFIDENT DENTAL PC

MEDICARE: CONFIDENT DENTAL PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry052854NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
29217339OTHERNYDORAL

General Provider Information

NPI Number : 1295976025
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONFIDENT DENTAL PC
Provider Business Mailing Address
First Line : 1241 NOSTRAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11225-3844
Country : US
Telephone Number : 718-484-7505
Fax Number :
Provider Business Practice Location Address
First Line : 1241 NOSTRAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11225-3844
Country : US
Telephone Number : 718-484-7505
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : DR. IGOR NELUBIN
Credential : DDS
Telephone Number : 718-484-7505
Provider Enumeration Date : 03/06/2009
Last Update Date : 03/06/2009

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