Healthcare Provider Details

I. General information

NPI: 1437123015
Provider Name (Legal Business Name): KARLA WENDY ISAACS D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 EAST 184TH STREET
BRONX NY
10458
US

IV. Provider business mailing address

565 EAST 184TH STREET
BRONX NY
10458
US

V. Phone/Fax

Practice location:
  • Phone: 718-220-8800
  • Fax: 718-220-8706
Mailing address:
  • Phone: 718-220-8800
  • Fax: 718-220-8706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number0476071
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: