Provider Demographics
NPI:1730153222
Name:KATZ, STEVEN (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:KATZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:
Other - Last Name:KATZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:NACHAL DOLEV # 44 / 2
Mailing Address - Street 2:
Mailing Address - City:RAMAT BEIT SHEMESH
Mailing Address - State:ISRAEL
Mailing Address - Zip Code:99621
Mailing Address - Country:IL
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:711B SEAGIRT AVE
Practice Address - Street 2:DENTAL OFFICE
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5730
Practice Address - Country:US
Practice Address - Phone:718-471-3366
Practice Address - Fax:718-471-3366
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044979122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01500403Medicaid