Advanced Dental of New York PC
Organization Active NPI Oral and Maxillofacial Surgery (Dentist) · Hollis, NY
NPI 1275830465 · NPPES record last updated Dec 15, 2017
Key facts
- NPI
- 1275830465
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 053869 (NY)
- Legal business name
- ADVANCED DENTAL OF NEW YORK PC
- Practice address
- 19711 Hillside Ave
Hollis, NY 11423-2126 - Phone
- (718) 740-6000
- Fax
- (718) 740-6004
- NPI assigned
- Feb 24, 2011
- Organization subpart
- No
Authorized official
- Name
- Benjamin Katayev, DDS
- Title
- President
- Phone
- (718) 740-6000
Practitioners 1
-
Isaak Yelizar, DDS
National Provider Directory
Locations
19711 Hillside Ave
Hollis, NY 11423
Phone (718) 740-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics |
1223E0200X | 054577 | NY | |
| Periodontics |
1223P0300X | 053253 | NY | |
| Oral and Maxillofacial Surgery (Dentist) |
1223S0112X | 053869 | NY | Yes |
Addresses
Primary practice location
19711 Hillside Ave
Hollis, NY 11423-2126
Mailing address
197-11 Hillside Avenue
Hollis, NY 11423-2516
Phone (718) 740-6000
Other names
- Advanced Dental Specialties of NY
Other providers in Hollis, NY
- Sibila Abramov
- Lourdes Acay Santos
- Gianna L Acosta
- Olusegun M Adeonigbagbe
- Lawanna Adkins
- Doina G Agbary
- Laurena Agnant
- Bhaveshkumar B Ahir
- Mayisha Ahsan-Khan
- Yashvanth Aitha
All providers in Hollis, NY · Oral and Maxillofacial Surgery (Dentist) in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.