MEDICARE: DR. SHIRI SHANI GREENBERG DMD

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	1223P0221X	Pediatric Dentistry	049090	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1578757589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHIRI SHANI GREENBERG DMD

Provider Business Mailing Address
First Line	:	23 MACY AVE
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-3542
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4303 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1337
Country	:	US
Telephone Number	:	718-871-9111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2007
Last Update Date	:	09/03/2007

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