Broadway Mall Dental

LBN: Broadway Mall Dental
Broadway Mall Dental is an health care organization with primary practice located at 200 Broadway Mall , Hicksville NY 11801. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Broadway Mall Dental can be contacted via phone (516) 933-3444, or through Levin, Igor via phone (516) 933-3444.

Contact Information

Primary practice address
200 Broadway Mall Hicksville NY 11801
Phone: (516) 933-3444
Fax: (516) 933-3445
Website:
Map and Directions
Authorized official contact:
Name: Levin, Igor Doctor of Dental Surgery (DDS)
Phone: (516) 933-3444

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X New York

Profile Details

NPI number 1225183551
LBN Legal business name Broadway Mall Dental
DBA Doing business as
Authorized official Levin, Igor Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 25th, 2007
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225183551 NPPES
New York MEDICAID 02757968

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