Stephen Dallal, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

034737 Issued in NY

Practice address

611 Northern Blvd
Great Neck Dental Associates
Great Neck, NY 11021-5201

Phone

(516) 487-5500

NPI assigned

Apr 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1639399710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 NORTHERN BLVD",
            "address_2": "GREAT NECK DENTAL ASSOCIATES",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215201",
            "telephone_number": "516-487-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 NORTHERN BLVD",
            "address_2": "GREAT NECK DENTAL ASSOCIATES",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215201",
            "telephone_number": "516-487-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLAL",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-30",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "034737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Czuj
• D.a.C. Physical Medicine, P.C. (North Shore Rehab Medicine)
• D&D Health Supplies Corp.
• Richard J Dagostino, MD
• Rhonda Lee Dallal, M.A., CCC, SLP
• Shirin Dalvi, PT
• Kathryn Daly
• Kelly Ann Damiani, PHARMD
• Michael Matthew Danber, M.D.
• Daniel Bassiri MD PLLC

• General Practice Dentistry in Great Neck, NY
• Providers in Great Neck, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.