Healthcare Provider Details

I. General information

NPI: 1730153222
Provider Name (Legal Business Name): STEVEN KATZ D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: STEVEN KATZ D.D.S.

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711B SEAGIRT AVE DENTAL OFFICE
FAR ROCKAWAY NY
11691-5730
US

IV. Provider business mailing address

NACHAL DOLEV # 44 / 2
RAMAT BEIT SHEMESH ISRAEL
99621
IL

V. Phone/Fax

Practice location:
  • Phone: 718-471-3366
  • Fax: 718-471-3366
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number044979
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: