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Contact Information

ADVANCED DENTAL OF NEW YORK PC
19711 HILLSIDE AVE
HOLLIS, NY11423-2126
 Phone: 718-740-6000
 Fax: 718-740-6004
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
 

Endodontics

1223E0200X
 

Periodontics

1223P0300X
Indicates primary specialty

NPI Profile & details for ADVANCED DENTAL OF NEW YORK PC

NPI Number 1275830465
LBN Legal business name ADVANCED DENTAL OF NEW YORK PC
Authorized official BENJAMIN KATAYEV - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 02/24/2011
Last updated 12/15/2017 - About 8 years ago
Identifiers
NY License # 053253
NY License # 053869
NY License # 054577
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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