Harborbay Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

048345-1 Issued in NY

Legal business name

HARBORBAY DENTAL

Practice address

160 Brentwood Rd
Bay Shore, NY 11706-6948

Phone

(631) 666-0427

Fax

(631) 647-7687

NPI assigned

Aug 19, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Steven Anthony Grandillo, DDS

Title

Dentist

Phone

(631) 666-0427

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1932489192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BRENTWOOD RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066948",
            "telephone_number": "631-666-0427",
            "fax_number": "631-647-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BRENTWOOD RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066948",
            "telephone_number": "631-666-0427",
            "fax_number": "631-647-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBORBAY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-19",
        "status": "A",
        "authorized_official_last_name": "GRANDILLO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "631-666-0427",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048345-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02699012",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth Hansen, M.A.
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• Colleen Harrington
• Kerri Harrington, LMSW
• Melissa Harris, M.S.CCC-SLP
• Shane Marie Harris, NP

• General Practice Dentistry in Bay Shore, NY
• Providers in Bay Shore, 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 Aug 19, 2011; 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.