ROBERT TEISCH & JOSEPH A SIMONETTI AND ROBERT DOMOZYCH DDS PC NPI 1821008160

NPI Information

NPI: 1821008160
Provider Name: ROBERT TEISCH & JOSEPH A SIMONETTI AND ROBERT DOMOZYCH DDS PC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
127 W MAIN ST
EAST ISLIP, NY
ZIP 11730
Phone: (631) 277-4848
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ROBERT TEISCH & JOSEPH A SIMONETTI AND ROBERT DOMOZYCH DDS PC is a dental clinic center in East Islip, NY. ROBERT TEISCH & JOSEPH A SIMONETTI AND ROBERT DOMOZYCH DDS PC NPI is 1821008160. The provider is registered as an organization entity type.

The provider's business location address is:

127 W MAIN ST
EAST ISLIP, NY
ZIP 11730-343
Phone: (631) 277-4848
Fax: (631) 277-4849

The provider's authorized official is Scott Simonetti .
The authorized official title is Dentist Partner and has the following contact phone number (631) 234-7979.

The enumeration date for this NPI number is 8/9/2006 and was last updated on 5/1/2015.

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	261QD0000X	Clinic/Center	Dental	50030265	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01435423	MEDICAID	NEW YORK

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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