Medina, Juana X
Medina, Juana X is an individual health care provider with primary practice located at 10105 77 St , Ozone Paark NY 11416. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Medina, Juana X can be contacted via phone (718) 323-1288.Contact Information
Primary practice address
10105 77 St
Ozone Paark NY 11416
Phone: (718) 323-1288
Fax: (718) 323-0291
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 0457981 | New York |
Profile Details
| NPI number | 1760532303 |
|---|---|
| LBN Legal business name | Medina, Juana X |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 12th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760532303 | NPPES |
| New York | MEDICAID | 01558754 |
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