MEDICARE: DR. VLAD S UMANSKY 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	122300000X	Dentist	043908	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	:	1891705638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VLAD S UMANSKY DDS

Provider Business Mailing Address
First Line	:	1364 CONEY ISLAND AVE
Second Line	:	2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11230
Country	:	US
Telephone Number	:	718-252-9222
Fax Number	:	718-252-0982

Provider Business Practice Location Address
First Line	:	1364 CONEY ISLAND AVE
Second Line	:	MIDWOOD DENTAL CENTER 2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11230
Country	:	US
Telephone Number	:	718-252-9222
Fax Number	:	718-252-0982

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	07/08/2007

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