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General NPI Number Information
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NPI Number | 1699824417
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Entity Type | Individual
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Provider Name | GADI DEKEL DMD
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Gender | Male
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 339 WYCKOFF AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-2753
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Country | US
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Telephone | 718-366-0662
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Fax |
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Provider Business Mailing Address
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Address Line | 14440 73RD AVE
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City | FLUSHING
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State | NY
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Zip | 11367-2413
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Country | US
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Telephone | 718-544-1648
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 047376-1
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License Number State | NY
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