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NPI Code Detail

MEDICARE: DR. DEAN NEVID DDS

MEDICARE: DR. DEAN NEVID DDS
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 Dentistry035401NY

General Provider Information

NPI Number : 1710976188
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEAN NEVID DDS
Provider Business Mailing Address
First Line : 255 RICHMOND HILL RD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5906
Country : US
Telephone Number : 718-494-2010
Fax Number : 718-761-4743
Provider Business Practice Location Address
First Line : 255 RICHMOND HILL RD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5906
Country : US
Telephone Number : 718-494-2010
Fax Number : 718-761-4743
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 07/08/2007

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