Hollis Advanced Dental Care P.C.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

HOLLIS ADVANCED DENTAL CARE P.C.

Practice address

19002 Jamaica Ave
2 Floor
Hollis, NY 11423-2516

Phone

(718) 454-7418

Fax

(718) 217-2657

NPI assigned

Aug 27, 2008

Last updated

Aug 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin V Katayev, D.D.S.

Title

President

Phone

(718) 454-7418

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1699922088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19002 JAMAICA AVE",
            "address_2": "2 FLOOR",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232516",
            "telephone_number": "718-454-7418",
            "fax_number": "718-217-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19002 JAMAICA AVE",
            "address_2": "2 FLOOR",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232516",
            "telephone_number": "718-454-7418",
            "fax_number": "718-217-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLIS ADVANCED DENTAL CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-27",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "KATAYEV",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-454-7418",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02587795",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011896900",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hillside Optimal Medical Care
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• Kyle Holder, OTR
• Whitney Quinn Hollins
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• Hollis Drugs Inc
• Hollis Medical Care, P.C.
• Hollis Medical Office
• Hollis Medical PC

• Dentist in Hollis, NY
• Providers in Hollis, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.