Prohealth Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PROHEALTH DENTAL PLLC

Practice address

5011 Vernon Blvd
Long Island City, NY 11101

Phone

(718) 650-5566

NPI assigned

Feb 27, 2019

Organization subpart

Yes

Parent organization

PROHEALTH DENTAL PLLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Natalya Korobeynyk

Title

RCM

Phone

(516) 654-4400

Specialties & licenses 5

Addresses

Part of

Prohealth Dental PLLC

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1003373903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 NEW HYDE PARK RD STE 310",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421205",
            "telephone_number": "516-654-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5011 VERNON BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "11101",
            "telephone_number": "718-650-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH DENTAL PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROHEALTH DENTAL PLLC",
        "enumeration_date": "2019-02-27",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "KOROBEYNYK",
        "authorized_official_first_name": "NATALYA",
        "authorized_official_title_or_position": "RCM",
        "authorized_official_telephone_number": "516-654-4400"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Long Island City, NY
• Providers in Long Island City, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.