MEDICARE: OCEANVIEW DENTAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043375488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEANVIEW DENTAL

Provider Business Mailing Address
First Line	:	3061 BRIGHTON 6TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-6409
Country	:	US
Telephone Number	:	718-332-0202
Fax Number	:	718-646-9669

Provider Business Practice Location Address
First Line	:	3061 BRIGHTON 6TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-6409
Country	:	US
Telephone Number	:	718-332-0202
Fax Number	:	718-646-9669

Authorized Official
Title or Position	:	PROVIDER
Name	:	DR. STEVEN VOLK
Credential	:	D.D.S
Telephone Number	:	516-944-7000

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	05/13/2008

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Directions to “OCEANVIEW DENTAL ” Practice Location

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