MEDICARE: D.A.N DMD LLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1508696568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D.A.N DMD LLC

Provider Business Mailing Address
First Line	:	181 18TH ST PH 1102
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-7508
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 E 35TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-3815
Country	:	US
Telephone Number	:	404-259-7571
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. DANIEL ARMIL NARAIN
Credential	:	DMD
Telephone Number	:	404-259-7571

Provider Enumeration Date	:	08/05/2024
Last Update Date	:	08/05/2024

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