Prohealth Dental PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

037989 Issued in NY

Legal business name

PROHEALTH DENTAL PLLC

Practice address

1 Pro Health PLZ
Suite 115
New Hyde Park, NY 11042

Phone

(516) 467-8191

Fax

(516) 467-8192

NPI assigned

Oct 7, 2015

Organization subpart

Yes

Parent organization

PROHEALTH DENTAL PLLCAs reported in NPPES

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 11

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Prohealth Dental PLLC

  • General Practice Dentistry
  • Yorktown Heights, NY
  • NPI 1336717628

  7911261847

  Same PAC ID
• Prohealth Dental PLLC

  • General Practice Dentistry
  • Huntington, NY
  • NPI 1477010148

  7911261847

  Same PAC ID

Tax ID family

Prohealth Dental PLLC11 organizations share this tax ID, including this one

Part of

Prohealth Dental PLLC

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

• Prohealth Dental PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Astoria, NY
  • NPI 1073131512
  NPD tax ID
• Prohealth Dental PLLC

  • General Practice Dentistry
  • Yonkers, NY
  • NPI 1114522232
  NPD tax ID
• Prohealth Dental PLLC

  • General Practice Dentistry
  • Garden City, NY
  • NPI 1245997592
  NPD tax ID
• Prohealth Dental PLLC

  • Dentist
  • Oceanside, NY
  • NPI 1275170219
  NPD tax ID
• Prohealth Dental PLLC

  • General Practice Dentistry
  • Rockville Centre, NY
  • NPI 1386101921
  NPD tax ID
• Prohealth Dental PLLC

  • Dentist
  • Lynbrook, NY
  • NPI 1437616075
  NPD tax ID
• Prohealth Dental PLLC

  • General Practice Dentistry
  • Huntington, NY
  • NPI 1477010148
  NPD tax ID
• Prohealth Dental PLLC

  • Dentist
  • New Hyde Park, NY
  • NPI 1497414965
  NPD tax ID
• Prohealth Dental PLLC

  • Dentist
  • White Plains, NY
  • NPI 1518509942
  NPD tax ID
• Prohealth Dental PLLC

  • Dentist
  • Bay Shore, NY
  • NPI 1548807894
  NPD tax ID

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1255701959",
    "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",
            "fax_number": "516-467-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PRO HEALTH PLZ",
            "address_2": "SUITE 115",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11042",
            "telephone_number": "516-467-8191",
            "fax_number": "516-467-8192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH DENTAL PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROHEALTH DENTAL PLLC",
        "enumeration_date": "2015-10-07",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "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": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "055531",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "042857",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "057838",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "053382",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "055400",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "037989",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "037623",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "043834",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "036753",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "049846",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Professional Primary Care Physician PLLC
• Progressive Physical Therapy Services, PC
• Progressive Surgical Care, PLLC
• Prohealth Accountable Care Medical Group PLLC
• Prohealth Ambulatory Surgery Center, LLC
• Prohealth Dental PLLC
• Promedica Imaging, P.C.
• Prompt Medical Spine Care
• Prosthodontic Assoc. of Long Island
• Prothotic Laboratory, Inc.

• Periodontics in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.