Brent L Deuink, D.M.D.
Individual provider Active NPI Dentist · Clymer, NY
NPI 1407071129 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1407071129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 035694 (NY)
- Practice address
- 327 Clymer-Corry Road
Clymer, NY 14724-0308 - Phone
- (716) 355-4244
- Fax
- (716) 355-4244
- NPI assigned
- Apr 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 035694 | NY | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 035694 | NY | Yes |
Addresses
Primary practice location
327 Clymer-Corry Road
Clymer, NY 14724-0308
Mailing address
327 Clymer Corry Road
P.O. Box 308
Clymer, NY 14724-0308
Phone (716) 355-4244
Other providers in Clymer, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.