Provider Demographics
NPI:1477687994
Name:THE NORTH SHORE CENTER FOR COMPREHENSIVE DENTISTRY
Entity Type:Organization
Organization Name:THE NORTH SHORE CENTER FOR COMPREHENSIVE DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ADRIAN
Authorized Official - Last Name:SHEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:516-627-2234
Mailing Address - Street 1:1025 NORTHERN BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1506
Mailing Address - Country:US
Mailing Address - Phone:516-627-2234
Mailing Address - Fax:516-627-7031
Practice Address - Street 1:1025 NORTHERN BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1506
Practice Address - Country:US
Practice Address - Phone:516-627-2234
Practice Address - Fax:516-627-7031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty