Organization Active NPI

The Smilist Dental Ma PLLC

  • General Practice Dentistry
  • Great Neck, NY
National Provider Identifier
1245001817
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
THE SMILIST DENTAL MA PLLC
Practice address
40 Cuttermill Rd Ste 500
Great Neck, NY 11021-3213
Phone
(562) 965-3304
NPI assigned
Jan 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Authorized official

Name
Saundra Alvarez
Title
VP Revenue MGMT
Phone
(562) 965-3304

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

40 Cuttermill Rd Ste 500
Great Neck, NY 11021-3213

Mailing address

40 Cuttermill Rd Ste 500
Great Neck, NY 11021-3213
Phone (562) 965-3304

National Provider Directory

National Provider Directory

Locations

40 Cuttermill Rd
Ste 500
Great Neck, NY 11021
Phone (562) 965-3304

NPI Registry JSON

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1245001817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CUTTERMILL RD STE 500",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213213",
            "telephone_number": "562-965-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CUTTERMILL RD STE 500",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213213",
            "telephone_number": "562-965-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SMILIST DENTAL MA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "SAUNDRA",
        "authorized_official_title_or_position": "VP REVENUE MGMT",
        "authorized_official_telephone_number": "562-965-3304"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.