Igor M Port, DDS is a
Dentist - General Practice based in Lic, New York. Igor M Port is licensed to practice in New York (license number 038281) and his current practice location is
24-16 Queens Plaza South, Igor Port Dds, Lic, New York. He can be reached at his office (for appointments etc.) via phone at
(718) 205-2020.
NPI number for Igor M Port is 1639429079 and his current mailing address is 24-16 Queens Plaza South, Igor Port Dds, Lic, New York. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1639429079.
Healthcare Provider's Profile
Full Name | Igor M Port |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 24-16 Queens Plaza South, Lic, New York |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1639429079
- Provider Enumeration Date: 09/13/2012
- Last Update Date: 09/13/2012
Medical Identifiers
Medical identifiers for Igor M Port such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1639429079 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 038281 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Igor M Port is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Igor M Port, DDS 24-16 Queens Plaza South, Igor Port Dds, Lic, NY 11101 Ph: (718) 205-2020 | Igor M Port, DDS 24-16 Queens Plaza South, Igor Port Dds, Lic, NY 11101 Ph: (718) 205-2020 |
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