MEDICARE: DR. ALEXANDER KHABENSKY 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
1	1223G0001X	General Practice Dentistry	046665	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	:	1881731503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER KHABENSKY DDS

Provider Business Mailing Address
First Line	:	2426 E 27TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-2004
Country	:	US
Telephone Number	:	718-891-5622
Fax Number	:

Provider Business Practice Location Address
First Line	:	1615 QUENTIN RD STE A1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1295
Country	:	US
Telephone Number	:	718-339-8852
Fax Number	:	718-339-9514

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

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	07/08/2007

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