Provider Demographics
NPI:1851734503
Name:DR. GREGORY P DOROSKI DMD
Entity Type:Organization
Organization Name:DR. GREGORY P DOROSKI DMD
Other - Org Name:CHASE DENTAL SLEEPCARE OF RIVERHEAD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:DOROSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-727-0770
Mailing Address - Street 1:887 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2115
Mailing Address - Country:US
Mailing Address - Phone:631-727-0770
Mailing Address - Fax:
Practice Address - Street 1:887 OLD COUNTRY RD
Practice Address - Street 2:SUITE B
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2115
Practice Address - Country:US
Practice Address - Phone:631-727-0770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035373122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAD9503625OtherDRUG ENFORCEMENT NUMBER