MEDICARE: ALAN DAVID WAINSTOCK DDS

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	29005	NY

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	:	1407982903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN DAVID WAINSTOCK DDS

Provider Business Mailing Address
First Line	:	125 CHESTNUT DRIVE
Second Line	:
City	:	ROSLYN
State	:	NY
Zip	:	11576
Country	:	US
Telephone Number	:	516-621-8110
Fax Number	:	516-621-9594

Provider Business Practice Location Address
First Line	:	2678 OCEAN AVENUE
Second Line	:	APT L6
City	:	BROOKLYN
State	:	NY
Zip	:	11229
Country	:	US
Telephone Number	:	718-646-1448
Fax Number	:	718-646-8282

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	07/08/2007

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