Evergreen Dentistry, Llc

LBN: Evergreen Dentistry, Llc
Evergreen Dentistry, Llc is an health care organization with primary practice located at 4748 203Rd St , Bayside NY 11361-3039. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. Evergreen Dentistry, Llc can be contacted via phone (718) 578-1126, or through Kim, Andrew via phone (718) 578-1126.

Contact Information

Primary practice address
4748 203Rd St Bayside NY 11361-3039
Phone: (718) 578-1126
Fax: (718) 578-1126
Website:
Map and Directions
Authorized official contact:
Name: Kim, Andrew Doctor of Dental Surgery (DDS)
Phone: (718) 578-1126

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X 050969 New York

Profile Details

NPI number 1790981579
LBN Legal business name Evergreen Dentistry, Llc
DBA Doing business as
Authorized official Kim, Andrew Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 26th, 2007
Last updated Aug 22nd, 2020 - about 4 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 1790981579 NPPES
New York MEDICAID 02685578

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