Provider Demographics
NPI:1073014700
Name:ASNIS DENTAL, PLLC
Entity Type:Organization
Organization Name:ASNIS DENTAL, PLLC
Other - Org Name:DENTAL365 MEDFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF INSURANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:SORIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-344-5746
Mailing Address - Street 1:3333 NEW HYDE PARK RD STE 414
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1224
Mailing Address - Country:US
Mailing Address - Phone:516-308-7646
Mailing Address - Fax:516-344-5748
Practice Address - Street 1:1645 ROUTE 112 STE A
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-3662
Practice Address - Country:US
Practice Address - Phone:631-289-1555
Practice Address - Fax:516-344-5748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty