North Shore Periodontics, PC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

043137 Issued in NY

Legal business name

NORTH SHORE PERIODONTICS, PC

Practice address

2001 Marcus Ave Ste E244
Suite E244
New Hyde Park, NY 11042-1011

Phone

(516) 706-2912

NPI assigned

Nov 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gregory Davis, DMD

Title

President

Phone

(516) 775-0018

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1679753669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE STE E244",
            "address_2": "SUITE E244",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421011",
            "telephone_number": "516-706-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE STE E244",
            "address_2": "SUITE E244",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421011",
            "telephone_number": "516-706-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE PERIODONTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-775-0018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "043137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Shore Long Island Jewish Health System
• North Shore Long Island Jewish Health System Foundation
• North Shore Long Island Jewish Medical Center
• North Shore Medical Group, PC
• North Shore Operative Surgery PC
• North Shore Podiatric Medicine & Surgery, P.C.
• North Shore Primary Care Medical Associates, PC
• North Shore University Hospital (NSLIJHS Medical Health Home)
• North Shore Vascular and Endovascular PLLC
• North Shore Vein PC

• Periodontics in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.