MEDICARE: DR. DAVID L SYKES DMD

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	D1012389	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	222318110	OTHER	NJ	NJ TAX ID#
2	D1012389	OTHER	NJ	NJ DENTAL LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629075460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID L SYKES DMD

Provider Business Mailing Address
First Line	:	524 MAPLE AVE
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1213
Country	:	US
Telephone Number	:	609-653-6300
Fax Number	:	609-653-4204

Provider Business Practice Location Address
First Line	:	524 MAPLE AVE
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1213
Country	:	US
Telephone Number	:	609-653-6300
Fax Number	:	609-653-4204

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	09/21/2007

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