MEDICARE: ATHEENA SARAN ANTONY

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	14447	CT

General Provider Information

NPI Number	:	1982466678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATHEENA SARAN ANTONY

Provider Business Mailing Address
First Line	:	563 8TH ST
Second Line	:
City	:	WEST HEMPSTEAD
State	:	NY
Zip	:	11552-1129
Country	:	US
Telephone Number	:	516-395-6756
Fax Number	:

Provider Business Practice Location Address
First Line	:	54 MAIN ST
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-3009
Country	:	US
Telephone Number	:	516-395-6756
Fax Number	:

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

Provider Enumeration Date	:	01/29/2024
Last Update Date	:	12/12/2025

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Directions to “ ATHEENA SARAN ANTONY ” Practice Location

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