Magic Smiles Dentistry of Lindenhurst, P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MAGIC SMILES DENTISTRY OF LINDENHURST, P.C.

Practice address

826 Buffalo Ave
Lindenhurst, NY 11757-1658

Phone

(631) 226-5437

NPI assigned

Jul 30, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Matthew NissenbaumNPI 1528192713

Title

President

Phone

(516) 982-2301

Specialties & licenses 1

Addresses

Practitioners 1

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

• Matthew A Nissenbaum, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lindenhurst, NY
  • NPI 1528192713
  NPD Authorized official

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1457024812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LEGENDS CIR",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475301",
            "telephone_number": "516-982-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 BUFFALO AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117571658",
            "telephone_number": "631-226-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGIC SMILES DENTISTRY OF LINDENHURST, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A",
        "authorized_official_last_name": "NISSENBAUM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-982-2301",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• LPM Services, Inc
• Dean Christopher Lumley
• Anli Luo
• Jeanne Marie Mackey, RN
• Jennifer A Mackie, MSED
• Amanda Maglione
• Patricia J Mahoney, RN
• John E Maiorino, P.A.
• Randolph Malsky, PHD
• Elizabeth P. Maltin, MD

• Dental Clinic/Center in Lindenhurst, NY
• Providers in Lindenhurst, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.