MEDICARE: 5B105STRDENTALPC

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	122300000X	Dentist	046206-1	NY

General Provider Information

NPI Number	:	1306052618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	5B105STRDENTALPC

Provider Business Mailing Address
First Line	:	5 BEACH 105TH ST
Second Line	:
City	:	ROCKAWAY PARK
State	:	NY
Zip	:	11694-2699
Country	:	US
Telephone Number	:	718-474-0007
Fax Number	:	718-474-0004

Provider Business Practice Location Address
First Line	:	5 BEACH 105TH ST
Second Line	:
City	:	ROCKAWAY PARK
State	:	NY
Zip	:	11694-2699
Country	:	US
Telephone Number	:	718-474-0007
Fax Number	:	718-474-0004

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. JOANNA KOWALEWSKI
Credential	:	DDS
Telephone Number	:	718-474-0007

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1053313148 — DR. BARRY D KURTZ DDS
Practice Location Address:

5 BEACH 105TH ST
ROCKAWAY PARK, NY
11694-2699

Practice Phone: 718-474-0007
Practice Fax: 718-474-0004

1659368710 — MICHAEL J DEMCHAK DC
Practice Location Address:

2699 LEE RD , SUITE 505
WINTER PARK, FL
32789-1753

Practice Phone: 407-960-3775
Practice Fax: 407-960-3652

1770564114 — GR8 CARE, INC.
Practice Location Address:

14518 LOS ANGELES ST
BALDWIN PARK, CA
91706-2699

Practice Phone: 626-337-7229
Practice Fax: 626-337-9456

1750368247 — MARTHA L. SPENCER MD
Practice Location Address:

3800 PARK NICOLETT BLVD. , PEDIATRIC ENDOCRINOLOGY
ST. LOUIS PARK, MN
55416-2699

Practice Phone: 952-993-3900
Practice Fax: 952-993-1761

1063483980 — DR. JEFFREY PETER ROSEN MD
Practice Location Address:

2699 LEE RD STE 100
WINTER PARK, FL
32789-1738

Practice Phone: 407-897-1363
Practice Fax: 407-254-2557

1689645426 — DR. STEPHEN R GOLL MD
Practice Location Address:

2699 LEE RD STE 100
WINTER PARK, FL
32789-1738

Practice Phone: 407-897-1363
Practice Fax: 407-254-2557

Directions to “5B105STRDENTALPC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.