Provider Demographics
NPI:1538259833
Name:FISHBEIN, JOSEPH S (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:S
Last Name:FISHBEIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:S
Other - Last Name:FISHBEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:2415 JERUSALEM AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1870
Mailing Address - Country:US
Mailing Address - Phone:516-679-1145
Mailing Address - Fax:516-679-2262
Practice Address - Street 1:2415 JERUSALEM AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1870
Practice Address - Country:US
Practice Address - Phone:516-679-1145
Practice Address - Fax:516-679-2262
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039272-11223P0300X
PADS024055L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics