Provider Demographics
NPI:1285812891
Name:SIEGEL, IRLENE ANTUNES (DDS)
Entity type:Individual
Prefix:DR
First Name:IRLENE
Middle Name:ANTUNES
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 MINEOLA BLVD
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2406
Mailing Address - Country:US
Mailing Address - Phone:516-294-2999
Mailing Address - Fax:516-294-8703
Practice Address - Street 1:245 MINEOLA BLVD
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2406
Practice Address - Country:US
Practice Address - Phone:516-294-2999
Practice Address - Fax:516-294-8703
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0432521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice