Provider Demographics
NPI:1447703889
Name:ABRAMOV, DANIEL (DMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ABRAMOV
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14030 69TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1637
Mailing Address - Country:US
Mailing Address - Phone:347-771-2460
Mailing Address - Fax:
Practice Address - Street 1:14030 69TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1637
Practice Address - Country:US
Practice Address - Phone:347-771-2460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ390200000122300000X
NY059971122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist