Provider Demographics
NPI:1598069379
Name:OASIS FAMILY DENTAL PLLC
Entity Type:Organization
Organization Name:OASIS FAMILY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:CHINLEI
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-441-4411
Mailing Address - Street 1:10911 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2335
Mailing Address - Country:US
Mailing Address - Phone:718-441-4411
Mailing Address - Fax:718-441-4412
Practice Address - Street 1:10911 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2335
Practice Address - Country:US
Practice Address - Phone:718-441-4411
Practice Address - Fax:718-441-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052214122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty