Healthcare Provider Details

I. General information

NPI: 1497303978
Provider Name (Legal Business Name): HINDIN DENTAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 EXECUTIVE BLVD STE 206
SUFFERN NY
10901-8218
US

IV. Provider business mailing address

2 EXECUTIVE BLVD STE 206
SUFFERN NY
10901-8218
US

V. Phone/Fax

Practice location:
  • Phone: 845-357-1595
  • Fax:
Mailing address:
  • Phone: 845-357-1595
  • Fax: 845-357-2428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: JEFFREY S. HINDIN
Title or Position: OWNER
Credential: DDS
Phone: 845-357-1595