MEDICARE: DR INNA GOYKMA AMIR DDS PC

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	261QD0000X	Dental Clinic/Center
2	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1972355311
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR INNA GOYKMA AMIR DDS PC

Provider Business Mailing Address
First Line	:	2952 BRIGHTON 3RD ST STE 501
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7079
Country	:	US
Telephone Number	:	718-234-5858
Fax Number	:	718-513-3456

Provider Business Practice Location Address
First Line	:	2952 BRIGHTON 3RD ST STE 501
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7079
Country	:	US
Telephone Number	:	718-234-5858
Fax Number	:	718-513-3456

Authorized Official
Title or Position	:	OWNER
Name	:	DR. INNA GOYKMAN AMIR
Credential	:	DDS
Telephone Number	:	917-513-5103

Provider Enumeration Date	:	04/01/2024
Last Update Date	:	03/05/2025

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