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General NPI Number Information
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NPI Number | 1407151715
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Entity Type | Organization
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Legal Business Name | HAMPTON BAYS DENTAL ASSOCIATES P.C.
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 188 W MONTAUK HWY STE 8
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City | HAMPTON BAYS
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State | NY
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Zip | 11946-2363
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Country | US
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Telephone | 631-728-8400
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Fax | 631-728-8482
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Provider Business Mailing Address
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Address Line | 188 W MONTAUK HWY STE 8
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City | HAMPTON BAYS
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State | NY
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Zip | 11946-2363
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Country | US
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Telephone | 631-728-8400
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Fax | 631-728-8482
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. KEVIN SHEREN
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Credential | D.D.S.
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Telephone | 631-728-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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