Active NPI
The Smilist Dental Ma PLLC
- General Practice Dentistry
- Great Neck, NY
National Provider Identifier
1245001817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 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 DirectoryLocations
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.