MEDICARE: ROXANNE BEATRICE BORDIES 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	047047	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	:	1497971261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROXANNE BEATRICE BORDIES DDS

Provider Business Mailing Address
First Line	:	13927 95TH AVE
Second Line	:	75 W RT. 59 NANUET NY 10977
City	:	JAMAICA
State	:	NY
Zip	:	11435-4408
Country	:	US
Telephone Number	:	718-926-5254
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 W ROUTE 59
Second Line	:
City	:	NANUET
State	:	NY
Zip	:	10954-2700
Country	:	US
Telephone Number	:	845-624-7500
Fax Number	:

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	03/22/2026

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