Provider Demographics
NPI:1285823047
Name:VEGA, ART (DDS)
Entity type:Individual
Prefix:DR
First Name:ART
Middle Name:
Last Name:VEGA
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 1:4 STUYVESANT OVAL APT 12E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2404
Mailing Address - Country:US
Mailing Address - Phone:917-658-3789
Mailing Address - Fax:
Practice Address - Street 1:221 AVENUE B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-3355
Practice Address - Country:US
Practice Address - Phone:646-960-9979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052456122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist