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General NPI Number Information
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NPI Number | 1073871281
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Entity Type | Individual
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Provider Name | AVA KAMENSHCHIK D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/25/2012
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Last Update Date | 07/10/2019
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Provider Practice Location Address
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Address Line | 99 COLD SPRING RD STE 101
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City | SYOSSET
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State | NY
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Zip | 11791-3140
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Country | US
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Telephone | 516-253-1016
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Fax |
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Provider Business Mailing Address
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Address Line | 99 COLD SPRING RD STE 101
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City | SYOSSET
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State | NY
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Zip | 11791-3140
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Country | US
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Telephone | 516-253-1016
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 058330-1
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License Number State | NY
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