Provider Demographics
NPI:1205032398
Name:TRUSMILE DENTAL, P.C.
Entity Type:Organization
Organization Name:TRUSMILE DENTAL, P.C.
Other - Org Name:CHENG Y. TSAI, D.D.S.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHENG-YING
Authorized Official - Middle Name:
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-809-1374
Mailing Address - Street 1:13630 SANFORD AVE
Mailing Address - Street 2:SUITE LB
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3137
Mailing Address - Country:US
Mailing Address - Phone:718-460-7868
Mailing Address - Fax:718-872-9684
Practice Address - Street 1:13630 SANFORD AVE
Practice Address - Street 2:SUITE LB
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3137
Practice Address - Country:US
Practice Address - Phone:718-460-7868
Practice Address - Fax:718-872-9684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0471071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02889389Medicaid