Provider Demographics
NPI:1750735320
Name:DAI, HARRISON (DDS)
Entity type:Individual
Prefix:DR
First Name:HARRISON
Middle Name:
Last Name:DAI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 UNION TPKE STE 208
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1759
Mailing Address - Country:US
Mailing Address - Phone:516-203-4403
Mailing Address - Fax:
Practice Address - Street 1:1300 UNION TPKE STE 208
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1759
Practice Address - Country:US
Practice Address - Phone:516-203-4403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059177-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice