Provider Demographics
NPI:1447642178
Name:ASNIS DENTAL, PLLC
Entity type:Organization
Organization Name:ASNIS DENTAL, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF DENTISTRY/ PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:G
Authorized Official - Last Name:ASNIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-502-4100
Mailing Address - Street 1:3333 NEW HYDE PARK RD STE 414
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1224
Mailing Address - Country:US
Mailing Address - Phone:516-344-5746
Mailing Address - Fax:516-344-5748
Practice Address - Street 1:211 W 79TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-799-7700
Practice Address - Fax:212-874-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0384601223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty