Organization Active NPI

Arista Dental Care, PC

  • General Practice Dentistry
  • Astoria, NY
National Provider Identifier
1851861264
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ARISTA DENTAL CARE, PC
Practice address
3027 30TH St
Astoria, NY 11102-2261
Phone
(718) 721-0330
NPI assigned
Nov 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Authorized official

Name
Michael Kokolis, D.D.S.NPI 1932282324
Title
Owner
Phone
(718) 721-0330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3027 30TH St
Astoria, NY 11102-2261

Mailing address

3027 30TH St
Astoria, NY 11102-2261
Phone (718) 721-0330

Other identifiers 1

IdentifierTypeStateIssuer
02299109MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210513001163 NY Part B Supplier - Clinic/Group Practice 1456760933 Receives reassigned benefits from 1 practitioner
Practice locations: Astoria, NY; Bayside, NY; Port Washington, NY

National Provider Directory

National Provider Directory

Locations

21435 42nd Ave
Bayside, NY 11361
Phone (718) 352-5582

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1851861264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3027 30TH ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022261",
            "telephone_number": "718-721-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3027 30TH ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022261",
            "telephone_number": "718-721-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARISTA DENTAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-28",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "KOKOLIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-721-0330",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02299109",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.