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General NPI Number Information
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NPI Number | 1730731563
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Entity Type | Individual
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Provider Name | DANIEL POPPER
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Gender | Male
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 245 E 21ST ST
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City | NEW YORK
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State | NY
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Zip | 10010-6410
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Country | US
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Telephone | 212-392-6520
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Fax |
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Provider Business Mailing Address
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Address Line | 223 W 14TH ST APT 1B
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City | NEW YORK
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State | NY
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Zip | 10011-7167
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Country | US
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Telephone | 561-317-9273
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 24365
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 062511
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License Number State | NY
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