Provider Demographics
NPI:1215918776
Name:KLEIN, NORMAN H (DDS)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:H
Last Name:KLEIN
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 1:820 OCEAN PKWY
Mailing Address - Street 2:APT 417
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2186
Mailing Address - Country:US
Mailing Address - Phone:917-545-1226
Mailing Address - Fax:
Practice Address - Street 1:22005 94TH DR
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428-2105
Practice Address - Country:US
Practice Address - Phone:718-465-3265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32454122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00367717Medicaid