Galleria Mall Dental Pc

LBN: Galleria Mall Dental Pc
Galleria Mall Dental Pc is an health care organization with primary practice located at 100 Main St , White Plains NY 10601-2601. The organization recently has 4 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry, Dental Providers / Periodontics, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / General Practice is the primary health care specialty. Galleria Mall Dental Pc can be contacted via phone (914) 997-9000, or through Krasnov, Ross via phone (914) 997-9000.

Contact Information

Primary practice address
100 Main St White Plains NY 10601-2601
Phone: (914) 997-9000
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Krasnov, Ross Doctor of Dental Surgery (DDS)
Phone: (914) 997-9000

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 046043 New York
Dental Providers / General Practice 1223G0001X 052674 New York
Dental Providers / General Practice 1223G0001X 052119 New York
Dental Providers / General Practice 1223G0001X 050148 New York
Dental Providers / General Practice 1223G0001X 052112 New York
Dental Providers / Pediatric Dentistry 1223P0221X 048760 New York
Dental Providers / Periodontics 1223P0300X 042707 New York
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 048185 New York

Profile Details

NPI number 1023155470
LBN Legal business name Galleria Mall Dental Pc
DBA Doing business as
Authorized official Krasnov, Ross Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 1st, 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 1023155470 NPPES
New York MEDICAID 02598167

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