Provider Demographics
NPI:1902989858
Name:MAGID, DAVID K (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:MAGID
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 1:52 GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2012
Mailing Address - Country:US
Mailing Address - Phone:917-416-8296
Mailing Address - Fax:
Practice Address - Street 1:880 RIVER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-9431
Practice Address - Country:US
Practice Address - Phone:718-992-0410
Practice Address - Fax:718-538-4323
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0504041223G0001X
NJ22DI02451000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist