Organization Active NPI

Williston Orthodontic PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Mineola, NY
National Provider Identifier
1871249359
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
WILLISTON ORTHODONTIC PC
Doing business as
Williston Orthodontics
Practice address
51 Charles St
Mineola, NY 11501-1941
Phone
(516) 746-3204
NPI assigned
Feb 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Authorized official

Name
Faith Gaskins
Title
Director of Credentialing
Phone
(972) 869-3789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

51 Charles St
Mineola, NY 11501-1941

Mailing address

51 Charles St
Mineola, NY 11501-1941
Phone (516) 746-3204

Other names 1

  • Williston Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

51 Charles St
Mineola, NY 11501
Phone (516) 746-3204

Practitioners & affiliated clinicians

Practitioners 3

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": "1645574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1871249359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 CHARLES ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115011941",
            "telephone_number": "516-746-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 CHARLES ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115011941",
            "telephone_number": "516-746-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLISTON ORTHODONTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "GASKINS",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Williston Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.