MEDICARE: DR. DAISUKE OSANAI 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	052387	NY

General Provider Information

NPI Number	:	1659528982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAISUKE OSANAI DDS

Provider Business Mailing Address
First Line	:	2129 31ST AVE
Second Line	:	APT 1B
City	:	ASTORIA
State	:	NY
Zip	:	11106-4521
Country	:	US
Telephone Number	:	917-477-9209
Fax Number	:

Provider Business Practice Location Address
First Line	:	2129 31ST AVE
Second Line	:	APT 1B
City	:	ASTORIA
State	:	NY
Zip	:	11106-4521
Country	:	US
Telephone Number	:	917-477-9209
Fax Number	:

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

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	11/06/2009

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