Sherwin Benlevi, DDS

Individual provider Active NPI General Practice Dentistry · Hollis, NY

NPI 1558675686 · NPPES record last updated Jul 30, 2010

Key facts

NPI
1558675686
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
0547291 (NY)
Practice address
19325 85TH Rd
Hollis, NY 11423-1133
Phone
(347) 878-2482
NPI assigned
Jul 30, 2010
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200609002932 NY Practitioner - Dentist 7618272816 Practice locations: New York, NY

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0547291NYMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0547291 NY Yes

Addresses

Primary practice location

19325 85TH Rd
Hollis, NY 11423-1133

Mailing address

19325 85TH Rd
Hollis, NY 11423-1133
Phone (347) 878-2482

Other providers in Hollis, NY

All providers in Hollis, NY · General Practice Dentistry in New York

Sources for this page

Verify at the official NPI Registry.