MEDICARE: OCEANSIDE GENTLE DENTAL

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
1	122300000X	Dentist	043490	NY

General Provider Information

NPI Number	:	1487985636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEANSIDE GENTLE DENTAL

Provider Business Mailing Address
First Line	:	3253 LONG BEACH RD
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-3649
Country	:	US
Telephone Number	:	516-442-2545
Fax Number	:	516-442-2546

Provider Business Practice Location Address
First Line	:	3253 LONG BEACH RD
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-3649
Country	:	US
Telephone Number	:	516-442-2545
Fax Number	:	516-442-2546

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. VLADIMIR LEMPERT
Credential	:	DMD
Telephone Number	:	516-442-2545

Provider Enumeration Date	:	01/27/2010
Last Update Date	:	01/27/2010

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Directions to “OCEANSIDE GENTLE DENTAL ” Practice Location

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