Provider Demographics
NPI:1669766051
Name:O & S DENTAL PLLC
Entity type:Organization
Organization Name:O & S DENTAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAISUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSANAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-672-7700
Mailing Address - Street 1:8905 ELMHURST AVE
Mailing Address - Street 2:UNIT A17
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1537
Mailing Address - Country:US
Mailing Address - Phone:718-672-7700
Mailing Address - Fax:718-672-7702
Practice Address - Street 1:8905 ELMHURST AVE
Practice Address - Street 2:UNIT A17
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1537
Practice Address - Country:US
Practice Address - Phone:718-672-7700
Practice Address - Fax:718-672-7702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0523871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty