Provider Demographics
NPI:1528237252
Name:VAIMAN, ALEXANDER E (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:E
Last Name:VAIMAN
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 1:87 WOLFS LN
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-1831
Mailing Address - Country:US
Mailing Address - Phone:914-738-3606
Mailing Address - Fax:914-738-3633
Practice Address - Street 1:87 WOLFS LN
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-1831
Practice Address - Country:US
Practice Address - Phone:914-738-3606
Practice Address - Fax:914-738-3633
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0401461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01711206Medicaid