MEDICARE: DR. CARY SCOTT BLUMENTHAL 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	1223G0001X	General Practice Dentistry	34929	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	:	1578544318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARY SCOTT BLUMENTHAL DDS

Provider Business Mailing Address
First Line	:	3447 21ST ST
Second Line	:	BLUMENTHAL & ASSOCIATES DDS PC
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-4721
Country	:	US
Telephone Number	:	718-786-8667
Fax Number	:	718-786-8531

Provider Business Practice Location Address
First Line	:	3447 21ST ST
Second Line	:	BLUMENTHAL & ASSOCIATES DDS PC
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-4721
Country	:	US
Telephone Number	:	718-786-8667
Fax Number	:	718-786-8531

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	07/08/2007

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