ADVANCED ORAL SURGERY OF STATEN ISLAND (NPI# 1700179124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700179124 |
| Entity Type | Organization |
| Organization Name | ADVANCED ORAL SURGERY OF STATEN ISLAND |
| Practice Address |
2025 Richmond Ave Suite Ll2 Staten Island NY 10314-3937 |
| Practice Telephone | 7182845500 |
| Practice Fax Number | 7182845600 |
| Mailing Telephone | 7182845500 |
| Mailing Fax Number | 7182845600 |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-05-18 |
| Authorized Official Name | MOSES D DATSON (OWNER/ORAL SURGEON) |
| Authorized Official Telephone | 7182845500 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
047288 | NY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02282231 | 05 |
| Street Address |
2025 RICHMOND AVE SUITE LL2 |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10314-3937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679550578 | Frank Tarantini | Surgery | 2025 Richmond Ave, Suite 1ll, Staten Island, NY 10314-3937 | 2005-12-30 |
| 1356984884 | Lisa Bilella Certified Registered Nurse Anesthetist Services of Ny Pll | Nurse Anesthetist, Certified Registered | 2025 Richmond Ave, Staten Island, NY 10314-3937 | 2019-10-28 |
| 1194239962 | Jacqueline Allen | Specialist/Technologist, Other | 2025 Richmond Ave, Staten Island, NY 10314-3937 | 2017-11-30 |
| 1932611621 | Eliana Sarit | Dentist | 2025 Richmond Ave, Staten Island, NY 10314-3937 | 2017-11-02 |
| 1710408257 | Heather Haim | Speech-Language Pathologist | 2025 Richmond Ave, Staten Island, NY 10314-3937 | 2017-07-06 |
| 1700318565 | Fran Bruno Md PC | Anesthesiology | 2025 Richmond Ave, Staten Island, NY 10314-3937 | 2017-03-31 |
| 1538604319 | Kelly Ann Callaghan | Specialist | 2025 Richmond Ave, Suite 200, Staten Island, NY 10314-3937 | 2017-01-03 |
| 1821530767 | Eunjung Lee | Specialist/Technologist | 2025 Richmond Ave, Staten Island, NY 10314-3937 | 2016-11-09 |
| 1659820041 | Cristina Smith | Specialist | 2025 Richmond Ave, 200, Staten Island, NY 10314-3937 | 2016-09-26 |
| 1033662150 | Stephanie Roxana Gutierrez | Specialist | 2025 Richmond Ave, Suite 200, Staten Island, NY 10314-3937 | 2016-07-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076255 | Edward Leccese | Massage Therapist | 77 Renee Place, Staten Island, NY 10314 | 2020-09-01 |
| 1871154633 | Matthew Richard Puliatti | Counselor | 1688 Victory Boulevard, Staten Island, NY 10314 | 2019-06-24 |
| 1750845137 | Miriam Gordon Pediatric Np PC | Nurse Practitioner | 7 Ismay Street, Staten Island, NY 10314 | 2019-01-30 |
| 1003391186 | 2791 Richmond LLC | Dentist | 2791 Richmond Avenue, Suite 2, Staten Island, NY 10314 | 2018-09-25 |
| 1477046522 | Miriam A Madry | Optometrist | 569 Woolley Ave, Staten Island, NY 10314 | 2018-06-13 |
| 1174025894 | Staten Island Dentistry P.C. | Clinic/Center | 979 Willowbrook Rd., Staten Island, NY 10314 | 2018-03-08 |
| 1205335023 | Ashley Larsen | Early Intervention Provider Agency | 229 Wellington Ct, Staten Island, NY 10314 | 2018-02-07 |
| 1306369699 | Victoria Ali | Behavior Technician | 228 Melvin Avenue, Staten Island, NY 10314 | 2017-07-19 |
| 1700307360 | Lydia Mora | Specialist | 2025 Richmond Avenue Suite 200, Staten Island, NY 10314 | 2017-07-03 |
| 1366971707 | Lisa Pietracatella | Massage Therapist | 92 Margaretta Court, Staten Island, NY 10314 | 2017-06-08 |
| Find all providers in zip 10314 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104338946 | Liberty Oral Surgery | Dentist | 201 Edward Curry Ave Ste 101, Staten Island, NY 10314-7102 | 2017-11-02 |
| 1225316961 | Paramount Oral Surgery and Dental Implant Center, LLC | Dentist | 201 Edward Curry Ave, Suite 101, Staten Island, NY 10314-7105 | 2011-07-29 |
| 1891000881 | Jerry Sherman | Dentist | 638 Bard Ave, 1st Floor, Staten Island, NY 10310-3020 | 2010-08-13 |
| 1740316413 | John A Lavinio | Dentist | 4300 Hylan Blvd, Staten Island, NY 10312-6505 | 2007-02-26 |
| 1760557417 | Richard Stephen Berk | Dentist | 3377 Richmond Avenue, Staten Island, NY 10312 | 2006-11-21 |
| 1063475424 | Jeremiah D'anna | Dentist | 4571 Hylan Blvd, Staten Island, NY 10312-6405 | 2006-04-07 |
| 1730178120 | Ralph Thomas Costagliola | Dentist | 71 Todt Hill Rd, Suite 106, Staten Island, NY 10314-4534 | 2005-10-18 |
| 1457785024 | Oral Surgery Associates P.C. | Dentist | 4300 Hylan Blvd, Suite 2g, Staten Island, NY 10312-6507 | 2013-08-30 |
| 1649542523 | Lydia Jane Lam | Dentist | 256 C Mason Ave, 3rd Floor, Staten Island, NY 10305 | 2012-02-07 |
| 1316217763 | Staten Island Oral & Maxillofacial Surgery | Dentist | 256 Mason Ave # C, Staten Island, NY 10305-3408 | 2012-01-03 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10314 |
Please comment or provide details below to improve the information on ADVANCED ORAL SURGERY OF STATEN ISLAND.
| 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.