Port Washington Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

052953 Issued in NY

Legal business name

PORT WASHINGTON DENTAL CARE

Practice address

18 Haven Avenue Suite 200
Port Washington, NY 11050-3643

Phone

(516) 944-5300

Fax

(516) 944-5304

NPI assigned

Mar 22, 2010

Last updated

May 13, 2025By 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. Michael Kokolis

Title

Owner/President

Phone

(516) 944-5300

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Liangyun Lo, DMD

  • General Practice Dentistry
  • Flushing, NY
  • NPI 1518653146
  NPD (past)

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1881918712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 HAVEN AVENUE SUITE 200",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503643",
            "telephone_number": "516-944-5300",
            "fax_number": "516-944-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 HAVEN AVENUE SUITE 200",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503643",
            "telephone_number": "516-944-5300",
            "fax_number": "516-944-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT WASHINGTON DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-22",
        "last_updated": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "KOKOLIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "516-944-5300",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052953",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049624",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02299109",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Port Counseling Center Inc
• Port Physical Therapy
• Port Salem Pharmacy Corp (Salem Drugs)
• Port Washington Dental
• Port Washington Dental Associates
• Port Washington Fire Department Inc
• Port Washington Hearing Center LLC
• Port Washington Medical Rehabilitation PLLC
• Port Washington Pharmacy Inc
• Port Washington Union Free School District

• General Practice Dentistry in Port Washington, NY
• Providers in Port Washington, 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 May 13, 2025; 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.