Provider Demographics
NPI:1104082494
Name:HUGHES, TED ALBERT (DMD)
Entity type:Individual
Prefix:DR
First Name:TED
Middle Name:ALBERT
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:TED
Other - Middle Name:ALBERT
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:200 CARMAN AVE APT 8D
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1151
Mailing Address - Country:US
Mailing Address - Phone:516-390-9850
Mailing Address - Fax:516-572-5379
Practice Address - Street 1:2201 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1859
Practice Address - Country:US
Practice Address - Phone:516-572-6895
Practice Address - Fax:516-572-5379
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190272601223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery