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General NPI Number Information
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NPI Number | 1336606144
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Entity Type | Individual
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Provider Name | TED TATSUSHI UOTANI DMD
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Gender | Male
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Dates
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Enumeration Date | 02/28/2019
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 506 LENOX AVE
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City | NEW YORK
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State | NY
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Zip | 10037-1889
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Country | US
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Telephone | 212-939-2848
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Fax |
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Provider Business Mailing Address
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Address Line | 227 E 86TH ST APT 3C
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City | NEW YORK
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State | NY
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Zip | 10028-3114
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Country | US
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Telephone | 832-212-6155
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 061282
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License Number State | NY
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