Organization Active NPI

Prohealth Dental PLLC

  • General Practice Dentistry
  • Howard Beach, NY
National Provider Identifier
1023575982
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PROHEALTH DENTAL PLLC
Practice address
16345 Crossbay Blvd
Howard Beach, NY 11414-3741
Phone
(718) 641-3838
NPI assigned
Feb 27, 2019
Organization subpart
Yes
Parent organization
PROHEALTH DENTAL PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

16345 Crossbay Blvd
Howard Beach, NY 11414-3741

Mailing address

3333 New Hyde Park Rd Ste 310
New Hyde Park, NY 11042-1205
Phone (516) 654-4400

National Provider Directory

National Provider Directory
Part of
Prohealth Dental PLLC

NPI Registry JSON

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": "1023575982",
    "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": "16345 CROSSBAY BLVD",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114143741",
            "telephone_number": "718-641-3838"
        }
    ],
    "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": []
}

Other providers in Howard Beach, NY

Sources for this page

  • 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.