# ADVANCED DENTAL OF NEW YORK PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Dental Specialties of NY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275830465
- **Authorized official:** BENJAMIN KATAYEV DDS (PRESIDENT)
- **Authorized official phone:** (718) 740-6000

## Contact information

- **Practice address:** 19711 HILLSIDE AVE, HOLLIS, NY 11423-2126
- **Practice address phone:** (718) 740-6000
- **Practice address fax:** (718) 740-6004
- **Mailing address:** 197-11 HILLSIDE AVENUE, HOLLIS, NY 11423-2516
- **Mailing address phone:** (718) 740-6000
- **Mailing address fax:** (718) 740-6004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 054577 | NY | — |
| 1223P0300X | Periodontics | 053253 | NY | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 053869 | NY | Yes |

## Other

- **Enumeration date:** 02/24/2011
- **Last updated:** 12/15/2017