Provider Demographics
NPI:1679802524
Name:LANDAU, ANNA K (DDS)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:K
Last Name:LANDAU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:KASPEROWICZ
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:16 RIDGE TERRACE
Mailing Address - Street 2:ANNA K. LANDAU
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078
Mailing Address - Country:US
Mailing Address - Phone:201-259-0514
Mailing Address - Fax:973-921-0350
Practice Address - Street 1:345 E 24TH STREET
Practice Address - Street 2:NYU COLLEGE OF DENTISTRY DEPARTMENT OF CARIOLOGY & COMP
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:212-998-9680
Practice Address - Fax:212-995-4955
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032041-1122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice