2791 Richmond LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

2791 RICHMOND LLC

Practice address

2791 Richmond Avenue, Suite 2
Staten Island, NY 10314

Phone

(718) 400-9002

NPI assigned

Sep 25, 2018

Organization subpart

No

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

Authorized official

Name

Toni Lynn Egan

Title

Credentialing Department

Phone

(718) 979-2121

Specialties & licenses 1

Addresses

Other names 1

• Oakwood Dental Arts by the Mall Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kamil Michael Kuflewski

  • Dentist
  • Staten Island, NY
  • NPI 1295350619
  NPD (past)
• Simratjit Lehal, DDS

  • Dentist
  • Staten Island, NY
  • NPI 1992449284
  NPD (past)
• Jared Miller, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Long Island City, NY
  • NPI 1417354457
  NPD (past)

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537833600000",
    "number": "1003391186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2791 RICHMOND AVE STE 2",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145859",
            "telephone_number": "718-400-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2791 RICHMOND AVENUE, SUITE 2",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-400-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2791 RICHMOND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-09-25",
        "status": "A",
        "authorized_official_last_name": "EGAN",
        "authorized_official_first_name": "TONI LYNN",
        "authorized_official_title_or_position": "CREDENTIALING DEPARTMENT",
        "authorized_official_telephone_number": "718-979-2121"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakwood Dental Arts by the Mall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• #1 Perfect Choice Inc.
• 1534 Victory DME, LLC
• 1975 Victory Chiropractic PC
• 4Ever Good Adult Daycare Center Inc
• 5 Boro Podiatry PC
• 5Borointervention Inc
• A & S Educational Technology Inc.
• A B a Professional Services

• General Practice Dentistry in Staten Island, NY
• Providers in Staten Island, 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 Sep 25, 2018; 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.