Provider Demographics
NPI:1699878777
Name:GINSBURG, RENATA (DDS)
Entity type:Individual
Prefix:
First Name:RENATA
Middle Name:
Last Name:GINSBURG
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 1:2280 GRAND AV
Mailing Address - Street 2:209
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510
Mailing Address - Country:US
Mailing Address - Phone:516-867-8466
Mailing Address - Fax:516-867-8042
Practice Address - Street 1:2280 GRAND AV
Practice Address - Street 2:209
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510
Practice Address - Country:US
Practice Address - Phone:516-867-8466
Practice Address - Fax:516-867-8042
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY41672122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist