Healthcare Provider Details

I. General information

NPI: 1124431499
Provider Name (Legal Business Name): SIDNEY N. CAPLIN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 06/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 JERICHO TURNPIKE
SYOSSET NY
11791
US

IV. Provider business mailing address

56 EAGLE CHASE
WOODBURY NY
11797
US

V. Phone/Fax

Practice location:
  • Phone: 516-364-1333
  • Fax:
Mailing address:
  • Phone: 516-364-1333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number23133
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: