Lazarus Camesas, DDS

Individual provider Active NPI General Practice Dentistry · Selden, NY

NPI 1619087897 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1619087897
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
034753 (NY)
Practice address
280 Middle Country Rd Ste K
Selden, NY 11784-2532
Phone
(631) 732-9000
Fax
(631) 736-7982
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
034753NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Coram Selden Dental Group PLLC General Practice Past
since Feb 8, 2023
Accepting new patients
Coarm-Selden Dental Group General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 034753 NY Yes

Addresses

Primary practice location

280 Middle Country Rd Ste K
Selden, NY 11784-2532

Mailing address

280 Middle Country Rd Ste K
Selden, NY 11784-2532
Phone (631) 732-9000

Other providers in Selden, NY

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

Sources for this page

Verify at the official NPI Registry.