NPIMap

Organization Active NPI

Long Island Oral Surgery Associates, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Great Neck, NY
National Provider Identifier
1306201066
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
052978 Issued in NY
Legal business name
LONG ISLAND ORAL SURGERY ASSOCIATES, PC
Practice address
1000 Northern Blvd
Suite 180
Great Neck, NY 11021-5338
Phone
(516) 487-4100
Fax
(516) 487-4041
NPI assigned
Dec 23, 2015
Organization subpart
Yes
Parent organization
LONG ISLAND ORAL SURGERY ASSOCIATES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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

Authorized official

Name
Mrs. Kathy Larson
Title
Office Manager
Phone
(516) 487-4100

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 052978 NY Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 041527 NY
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 044656 NY
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 057517-1 NY

Addresses

Primary practice location

1000 Northern Blvd
Suite 180
Great Neck, NY 11021-5338

Mailing address

959 Brush Hollow Rd
Suite 102
Westbury, NY 11590-1778
Phone (516) 333-5900

Other names 1

  • Long Island Center for Oral and Maxillofacial Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Long Island Center for Oral5 organizations share this tax ID, including this one
Part of
Long Island Center for Oral

Other organizations with this tax ID 4

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

Locations

1000 Northern Blvd
Ste 180
Great Neck, NY 11021
Phone (516) 487-4100

959 Brush Hollow Rd
Ste 102
Westbury, NY 11590
Phone (516) 333-5900

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1306201066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 BRUSH HOLLOW RD",
            "address_2": "SUITE 102",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901778",
            "telephone_number": "516-333-5900",
            "fax_number": "516-333-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NORTHERN BLVD",
            "address_2": "SUITE 180",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215338",
            "telephone_number": "516-487-4100",
            "fax_number": "516-487-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND ORAL SURGERY ASSOCIATES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LONG ISLAND ORAL SURGERY ASSOCIATES, PC",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "516-487-4100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "052978",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "041527",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "044656",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "057517-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Island Center for Oral and Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 23, 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.