DISTINCTIVE DENTAL SERVICES OF NEW YORK PC NPI 1205970332

NPI Information

NPI: 1205970332
Provider Name: DISTINCTIVE DENTAL SERVICES OF NEW YORK PC
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

CLIA Number: 33D2173158

Address:
173 E SHORE RD
SUITE 201
GREAT NECK, NY
ZIP 11023
Phone: (516) 487-8110
Get Directions

DISTINCTIVE DENTAL SERVICES OF NEW YORK PC is a pediatric dentistry dentist in Great Neck, NY. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DISTINCTIVE DENTAL SERVICES OF NEW YORK PC NPI is 1205970332. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

173 E SHORE RD
SUITE 201
GREAT NECK, NY
ZIP 11023-415
Phone: (516) 487-8110
Fax: (516) 487-8394

The provider's authorized official is Ralph Harris Epstein .
The authorized official title is President and has the following contact phone number (516) 487-8110.

The CLIA number assigned to this NPI record is 33D2173158 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/20/2007 and was last updated on 6/18/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice			No
2	1223D0004X	Dentist	Dentist Anesthesiologist	34227	NEW YORK	No
3	122300000X	Dentist		054882	NEW YORK	No
4	1223D0004X	Dentist	Dentist Anesthesiologist	054882	NEW YORK	No
5	1223P0221X	Dentist	Pediatric Dentistry			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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