Healthcare Provider Details

I. General information

NPI: 1366652406
Provider Name (Legal Business Name): EVAN MICHAEL TEMKIN D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1053 SAW MILL RIVER RD
ARDSLEY NY
10502-1048
US

IV. Provider business mailing address

441 CENTRAL PARK AVE UNIT 351
SCARSDALE NY
10530-7725
US

V. Phone/Fax

Practice location:
  • Phone: 516-840-6004
  • Fax: 646-224-8474
Mailing address:
  • Phone: 516-840-6004
  • Fax: 646-224-8474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number22DI02988900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number042445-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number042445
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: