Evergreen Dentistry, Llc in Bayside - Dental
Evergreen Dentistry, Llc - NPI 1790981579
Evergreen Dentistry, Llc is a Dental in Bayside, New York. Evergreen Dentistry, Llc practices all healthcare services and medical treatments related to Dental. The NPI Number for Evergreen Dentistry, Llc is 1790981579. The last update date is 2020-08-22.
Evergreen Dentistry, Llc's current location address is 4748 203rd St, Bayside, New York. You can contact this provider via phone number 7185781126 and fax number 7185781126. The mailing address for Evergreen Dentistry, Llc is 4748 203rd St, Bayside, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Evergreen Dentistry, Llc |
|---|---|
| Address | 4748 203rd St, Bayside, New York |
| Phone Number | 7185781126 |
| Fax Number | 7185781126 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Kim Andrew |
| Credentials | DDS |
| Telephone Number | 7185781126 |
NPI Number Detail
| NPI Number | 1790981579 |
|---|---|
| Provider Enumeration Date | 2007-06-26 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 4748 203rd St |
|---|---|
| City | Bayside |
| State | New York (NY) |
| Post Code | 113613039 |
| Phone Number | 7185781126 |
| Fax Number | 7185781126 |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
| Licence No | 50969 |
|
Definition: Provides general and specialized dental care and oral surgery. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2685578 | NY | -- |
Post Comment/ Review Below
What is the Evergreen Dentistry, Llc's 1790981579?
The Evergreen Dentistry, Llc's NPI (National Provider Identifier) Number is 1790981579. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Evergreen Dentistry, Llc's physical address?
The Evergreen Dentistry, Llc is physically located at 4748 203Rd St, in the city of Bayside, NY, with the postal code 113613039.
What is Evergreen Dentistry, Llc's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Evergreen Dentistry, Llc is Dental, and the taxonomy classification code that categorizes this area of expertise is 261Qd0000X.
When was the Evergreen Dentistry, Llc's 1790981579 issued?
The Evergreen Dentistry, Llc's 1790981579 was issued on 2007-06-26.
As of what date was the information pertaining to Evergreen Dentistry, Llc, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Evergreen Dentistry, Llc, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2020-08-22.