MEDICARE: DR. MICHAEL EVAN NEWMAN D.D.S.

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	1223E0200X	Endodontics	048686	NY
2	1223E0200X	Endodontics	DN 15718	FL

General Provider Information

NPI Number	:	1407078124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL EVAN NEWMAN D.D.S.

Provider Business Mailing Address
First Line	:	126 WINDWARD DR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4010
Country	:	US
Telephone Number	:	917-653-7270
Fax Number	:

Provider Business Practice Location Address
First Line	:	13722 S JOG RD STE B
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-5909
Country	:	US
Telephone Number	:	561-258-9947
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	06/07/2021

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