NORTH SHORE PERIODONTICS, PC (NPI# 1679753669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679753669 |
| Entity Type | Organization |
| Organization Name | NORTH SHORE PERIODONTICS, PC |
| Practice Address |
2001 Marcus Ave Ste E244 Suite E244 New Hyde Park NY 11042-1011 |
| Practice Telephone | 5167062912 |
| Mailing Telephone | 5167062912 |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |
| Authorized Official Name | DR. GREGORY DAVIS (PRESIDENT) |
| Authorized Official Telephone | 5167750018 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
043137 | NY | Dental Providers |
| Street Address |
2001 MARCUS AVE STE E244 SUITE E244 |
| City | NEW HYDE PARK |
| State | NY |
| Zip Code | 11042-1011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871260 | Advanced Cardiovascular Diagnostics, Pllc | Internal Medicine | 410 Lakeville Road Suite 209, New Hyde Park, NY 11042 | 2020-11-02 |
| 1568093771 | Global Slp Ot Pt & Psychological Services, Pllc | Physical Therapist | 1979 Marcus Avenue - Suite 204, Attn: Jon Polish, Lake Success, NY 11042 | 2020-01-28 |
| 1730745761 | Miriam Korbman | Psychologist | 2001 Marcus Ave Suite E128, Lake Success, NY 11042 | 2019-05-15 |
| 1306402409 | Swachi Jain | Student in an Organized Health Care Education/Training Program | Northwell Health Pathology, 6 - Ohio Drive, Suite 202, Lake Success, NY 11042 | 2019-05-14 |
| 1215407432 | Samara Carly Badash | Physical Therapist | Brookville Center for Children's Services, 1983 Marcus Avenue, Suite E100, New Hyde Park, NY 11042 | 2018-11-30 |
| 1720578578 | Nidhi Kataria | Student in an Organized Health Care Education/Training Program | Department of Pathology and Laboratory Medicine, Northw, 6 Ohio Drive, Suite 202, Lake Success, NY 11042 | 2018-05-17 |
| 1558870162 | Rosemary Elizabeth Fine | Nurse Practitioner | 1999 Marcus Ave Ste 306, New Hyde Park, NY 11042 | 2017-09-26 |
| 1255861159 | Nicole Renee Cohen | Speech-Language Pathologist | 1893 Marcus Ave, C118, New Hyde Park, NY 11042 | 2017-06-14 |
| 1366807943 | Molly Rubinoff | Nurse Practitioner | 1215 One Hollow Lane, #301, New Hyde Park, NY 11042 | 2015-12-23 |
| 1255701959 | Prohealth Dental Pllc | Dentist | 1 Pro Health Plz, Suite 115, New Hyde Park, NY 11042 | 2015-10-07 |
| Find all providers in zip 11042 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992358311 | Allie Luxenberg | Dentist | 700 Hillside Ave, New Hyde Park, NY 11040-2531 | 2019-07-24 |
| 1942407895 | Michael Stuart Shreck | Dentist | 1300 Union Tpke, New Hyde Park, NY 11040-1759 | 2007-07-02 |
| 1043417991 | Lake Success Periodontics and Implants P.C. | Dentist | 1300 Union Tpke, Suite 201, New Hyde Park, NY 11040-1759 | 2007-07-02 |
| 1649320466 | Harvey W. Glicker,dds,pc | Dentist | 700 Hillside Ave, New Hyde Park, NY 11040-2513 | 2007-01-12 |
| 1114077989 | Harvey Glicker | Dentist | 700 Hillside Ave, New Hyde Park, NY 11040-2513 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467052068 | Tamar Friling | Dentist | 247 3rd Ave Rm 203, New York, NY 10010-7453 | 2020-11-01 |
| 1851901896 | Kristen Brocavich | Dentist | 150 Islip Ave Ste 11, Islip, NY 11751-3222 | 2020-08-04 |
| 1962056499 | Zahavi Dental of Rochester | Dentist | 1815 S. Clinton Ave, 510, Rocheter, NY 14618 | 2019-08-01 |
| 1346710241 | Bedford Hills Dental P.C. | Dentist | 3 Depot Plz, Bedford Hills, NY 10507-1807 | 2018-12-04 |
| 1093295735 | Giffords Dental, P.C. | Dentist | 79 Giffords Ln, Staten Island, NY 10308-2411 | 2018-08-21 |
| 1215416805 | Alex Zusin | Dentist | 2540 Batchelder St Apt 5o, Brooklyn, NY 11235-1530 | 2018-08-14 |
| 1639655764 | Kiss Dental Care Pllc | Dentist | 425 Robinson Ave Ste 4, Newburgh, NY 12550-3303 | 2018-07-11 |
| 1689189524 | Mid Island Dental Specialists, PC | Dentist | 400 S Oyster Bay Rd Ste 201, Hicksville, NY 11801-3500 | 2017-12-13 |
| 1477068906 | Mohammad Reshad | Dentist | 230 Riverside Dr Apt 10m, New York, NY 10025-6192 | 2017-12-06 |
| 1043724479 | Ioana Chesnoiu Matei | Dentist | 630 W 168th St Rm 7-200c, New York, NY 10032-3725 | 2017-11-21 |
| Find all providers with the same taxonomy | ||||
| City | NEW HYDE PARK |
| Zip Code | 11042 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.