Provider Demographics
NPI:1235512641
Name:ASNIS DENTAL, PLLC
Entity Type:Organization
Organization Name:ASNIS DENTAL, PLLC
Other - Org Name:DENTAL365
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:ASNIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-502-4100
Mailing Address - Street 1:2001 MARCUS AVE
Mailing Address - Street 2:W90
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2061
Mailing Address - Country:US
Mailing Address - Phone:516-502-4100
Mailing Address - Fax:
Practice Address - Street 1:3254 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1345
Practice Address - Country:US
Practice Address - Phone:516-502-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038460122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty