Smith Haven Dentistry, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SMITH HAVEN DENTISTRY, PLLC

Practice address

2233 Nesconset Hwy
Ste #101
Lake Grove, NY 11755-1000

Phone

(631) 588-3636

NPI assigned

May 12, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Thomas R Douglas

Title

Sole Member

Phone

(631) 588-3636

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Edward M Bram, D.M.D.

  • General Practice Dentistry
  • Lake Grove, NY
  • NPI 1114930666
  NPD (past)

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1144608936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 NESCONSET HWY",
            "address_2": "STE #101",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551000",
            "telephone_number": "631-588-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 NESCONSET HWY",
            "address_2": "STE #101",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551000",
            "telephone_number": "631-588-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH HAVEN DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-12",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "631-588-3636",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kuldeep Singh, NURSE PRACTITIONER
• Ghazal Sinha, M.D
• Hannah Skylar Sledge, PA
• Mitchell Slochower, L.C.S.W.
• Smith Haven Dental PLLC
• Douglas Andrew Smith, RN
• Jessi M Smith, SLP
• Teresa Smith, RN
• Dawn Lynn Spring
• Scott A Stein, D.O.

• Dental Clinic/Center in Lake Grove, NY
• Providers in Lake Grove, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.