Healthcare Provider Details

I. General information

NPI: 1477239317
Provider Name (Legal Business Name): CARMEN C ESPINAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 S BROADWAY STE 210
YONKERS NY
10705-6202
US

IV. Provider business mailing address

65 HAYWARD ST
YONKERS NY
10704-1805
US

V. Phone/Fax

Practice location:
  • Phone: 914-965-9771
  • Fax: 845-765-9395
Mailing address:
  • Phone: 844-400-1975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number033840
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: