Healthcare Provider Details

I. General information

NPI: 1366772949
Provider Name (Legal Business Name): NEMAN FAMILY DENTISTRY P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2010
Last Update Date: 01/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 BAYVIEW AVE
GREAT NECK NY
11021-1719
US

IV. Provider business mailing address

64 BAYVIEW AVE
GREAT NECK NY
11021-1719
US

V. Phone/Fax

Practice location:
  • Phone: 516-773-4554
  • Fax:
Mailing address:
  • Phone: 516-773-4554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. NAHID NEMAN
Title or Position: DENTIST/OWNER
Credential: DMD
Phone: 516-773-4554