Bayside Laser Dental PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BAYSIDE LASER DENTAL PC

Practice address

3651 Bell Blvd
Bayside, NY 11361-2169

Phone

(718) 279-8588

Fax

(718) 631-6784

NPI assigned

Dec 14, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Hyang-Rim Lee, DDSNPI 1447313481

Title

President

Phone

(718) 279-8588

Specialties & licenses 2

Addresses

Other names 1

• Great Neck Laser Dental Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

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

• Hyang-Rim Lee, DDS

  • General Practice Dentistry
  • Bayside, NY
  • NPI 1447313481
  Medicare reassignment NPD Authorized official
• Derrick Hyun Ha, DDS

  • General Practice Dentistry
  • Rockville, MD
  • NPI 1487866810
  NPD (past)

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1598533903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612169",
            "telephone_number": "718-279-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612169",
            "telephone_number": "718-279-8588",
            "fax_number": "718-631-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE LASER DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-14",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "HYANG-RIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-279-8588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Neck Laser Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great Neck Laser Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bayside Family Dental Practice PC
• Bayside Family Dental, P.C.
• Bayside Family Eyecare Inc
• Bayside Family Pharmacy Inc.
• Bayside Laboratories
• Bayside Occupational Therapy PC
• Bayside Orthodontics PLLC
• Bayside Pediatric Care P.C.
• Bayside Pediatric Specialists P.C.
• Bayside Pediatrics PC

• Dental Clinic/Center in Bayside, NY
• Providers in Bayside, 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 Apr 2, 2024; 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.