Provider Demographics
NPI:1588863054
Name:OVERSTREET, MEREDITH JUNE (DDS)
Entity type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:JUNE
Last Name:OVERSTREET
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 1:1995 BROADWAY
Mailing Address - Street 2:STE. 200
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5882
Mailing Address - Country:US
Mailing Address - Phone:212-957-6459
Mailing Address - Fax:212-501-9471
Practice Address - Street 1:1995 BROADWAY
Practice Address - Street 2:STE. 200
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5882
Practice Address - Country:US
Practice Address - Phone:212-957-6459
Practice Address - Fax:212-501-9471
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053095-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist