Provider Demographics
NPI:1366747701
Name:SHMUELY AND SCHEVON DDS LLP
Entity type:Organization
Organization Name:SHMUELY AND SCHEVON DDS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AVIRAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHMUELY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-423-1999
Mailing Address - Street 1:21404 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1636
Mailing Address - Country:US
Mailing Address - Phone:718-423-1999
Mailing Address - Fax:718-423-1851
Practice Address - Street 1:21404 18TH AVE
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-1636
Practice Address - Country:US
Practice Address - Phone:718-423-1999
Practice Address - Fax:718-423-1851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0435251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty