MEDICARE: DEBRA D SPERLING 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	122300000X	Dentist	045368	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	:	1790825297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA D SPERLING DMD

Provider Business Mailing Address
First Line	:	171 IRMA DR
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-5716
Country	:	US
Telephone Number	:	718-549-8022
Fax Number	:	718-549-7977

Provider Business Practice Location Address
First Line	:	100 W MOSHOLU PKWY S
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-1001
Country	:	US
Telephone Number	:	718-549-8022
Fax Number	:

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	02/29/2020

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