Gold Coast Oral and Maxillofacial Surgery Syosset PLLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GOLD COAST ORAL AND MAXILLOFACIAL SURGERY SYOSSET PLLC

Practice address

40 Underhill Blvd
Syosset, NY 11791-3490

Phone

(516) 744-6262

Fax

(516) 744-6262

NPI assigned

Aug 7, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Steve Yusupov, DDS, MDNPI 1982991485

Title

Owner

Phone

(516) 749-3000

Specialties & licenses 2

Addresses

Other names 1

• Gold Coast Oral and Maxillofacial Surgery Doing business as

Locations

Practitioners 1

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

• Steve Yusupov, DDS, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Roslyn, NY
  • NPI 1982991485
  NPD Authorized official

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

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1922838432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 BRYANT AVE, SUITE 2",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "11576",
            "telephone_number": "516-749-3000",
            "fax_number": "516-749-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 UNDERHILL BLVD",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913490",
            "telephone_number": "516-744-6262",
            "fax_number": "516-744-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST ORAL AND MAXILLOFACIAL SURGERY SYOSSET PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "YUSUPOV",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-749-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gold Coast Oral and Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Denise Jean Glynn, MA.CCC.SLP
• Kyle Godden, PA-C
• Victoria Godino
• Gold Coast Gastroenterology P.C.
• Gold Coast Medical P C
• Arthur Goldberg, D.C.
• Brian Scott Goldberg, DC
• Jeffrey Alan Goldberg, D.D.S.
• Melissa Beth Goldberg, LCSW
• Kimberly Sarah Goldman

• Ambulatory Surgical Clinic/Center in Syosset, NY
• Providers in Syosset, NY by specialty
• Ambulatory Surgical Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.