Provider Demographics
NPI:1194874537
Name:FIALKOFF, BERNARD (DDS)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:
Last Name:FIALKOFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5603 214TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-1845
Mailing Address - Country:US
Mailing Address - Phone:718-229-3838
Mailing Address - Fax:718-229-0239
Practice Address - Street 1:5603 214TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-1845
Practice Address - Country:US
Practice Address - Phone:718-229-3838
Practice Address - Fax:718-229-0239
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYDS364381223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics