MEDICARE: JULES V. LANE, 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	019735	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	:	1659360881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULES V. LANE, DDS

Provider Business Mailing Address
First Line	:	35 BROADWAY
Second Line	:
City	:	HICKSVILLE
State	:	NY
Zip	:	11801-4266
Country	:	US
Telephone Number	:	516-822-8700
Fax Number	:	516-931-1010

Provider Business Practice Location Address
First Line	:	8710 GRAND AVE
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-4444
Country	:	US
Telephone Number	:	718-429-8300
Fax Number	:	516-931-1010

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JULES V LANE
Credential	:	D.D.S.
Telephone Number	:	516-822-8700

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	08/22/2020

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