Provider Demographics
NPI:1275172538
Name:NEW YORK SMILES ELMHURST
Entity Type:Organization
Organization Name:NEW YORK SMILES ELMHURST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-586-4444
Mailing Address - Street 1:8111 45TH AVE APT 1J
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3515
Mailing Address - Country:US
Mailing Address - Phone:718-424-5757
Mailing Address - Fax:
Practice Address - Street 1:8111 45TH AVE APT 1J
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3515
Practice Address - Country:US
Practice Address - Phone:718-424-5757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty