104 Dental, Pllc

LBN: 104 Dental, Pllc
104 Dental, Pllc is an health care organization with primary practice located at 10423 Roosevelt Avenue , Corona NY 11368-2327. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. 104 Dental, Pllc can be contacted via phone (718) 426-3000, or through Sakhaee, Artin via phone (718) 476-7801.

Contact Information

Primary practice address
10423 Roosevelt Avenue Corona NY 11368-2327
Phone: (718) 426-3000
Fax: (718) 426-3002
Website:
Map and Directions
Authorized official contact:
Name: Sakhaee, Artin Doctor of Dental Surgery (DDS)
Phone: (718) 476-7801

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 052701 New York

Profile Details

NPI number 1104356476
LBN Legal business name 104 Dental, Pllc
DBA Doing business as
Authorized official Sakhaee, Artin Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 19th, 2017
Last updated Jul 21st, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104356476 NPPES
New York MEDICAID 052701

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