Organization Active NPI

Hollywood Smile Dental

  • Dentist
  • Rego Park, NY
National Provider Identifier
1891639746
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
HOLLYWOOD SMILE DENTAL
Practice address
9750 Queens Blvd Ste G2
Rego Park, NY 11374-3211
Phone
(718) 830-0110
Fax
(718) 532-0456
NPI assigned
Apr 20, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Authorized official

Name
Dr. Yefim Khanimov, DDSNPI 1710067129
Title
Owner
Phone
(917) 604-6925

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

9750 Queens Blvd Ste G2
Rego Park, NY 11374-3211

Mailing address

611 Bridge St
Woodmere, NY 11598-1509
Phone (917) 604-6925

Other practice location 1

282A Sunrise Hwy
Rockville Centre, NY 11570-4906
Phone (516) 442-2111

National Provider Directory

National Provider Directory

Locations

9750 Queens Blvd
Ste G2
Rego Park, NY 11374
Phone (718) 830-0110

282A Sunrise Hwy
Rockville Centre, NY 11570
Phone (516) 442-2111

Practitioners & affiliated clinicians

Practitioners 1

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": "1776643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1891639746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 BRIDGE ST",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981509",
            "telephone_number": "917-604-6925",
            "fax_number": "718-532-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9750 QUEENS BLVD STE G2",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743211",
            "telephone_number": "718-830-0110",
            "fax_number": "718-532-0456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282A Sunrise Hwy",
            "address_purpose": "LOCATION",
            "city": "Rockville Centre",
            "state": "NY",
            "postal_code": "115704906",
            "country_code": "US",
            "telephone_number": "516-442-2111",
            "fax_number": "516-442-2112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOLLYWOOD SMILE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-19",
        "status": "A",
        "authorized_official_last_name": "KHANIMOV",
        "authorized_official_first_name": "YEFIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-604-6925",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; 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.