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General NPI Number Information
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NPI Number | 1831332733
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Entity Type | Organization
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Legal Business Name | KANE DENTAL OF HUNTINGTON
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Dates
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Enumeration Date | 04/08/2009
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 135 JERICHO TPKE
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-3649
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Country | US
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Telephone | 631-424-5900
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Fax | 631-292-2237
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Provider Business Mailing Address
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Address Line | 135 W. JERICHO TURNPIKE
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746
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Country | US
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Telephone | 631-424-5900
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Fax | 631-292-2237
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. REBEKAH KANE
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Credential | DDS
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Telephone | 631-424-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 052772-1
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License Number State | NY
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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 | 043267-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 052974-1
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 497891
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License Number State | NY
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