# RALLIS DENTISTRY OF BAYSIDE,PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578684866
- **Authorized official:** DR. NICHOLAS I. RALLIS D.D.S. (MEMBER)
- **Authorized official phone:** (718) 631-7800

## Contact information

- **Practice address:** 20920 35TH AVE, BAYSIDE, NY 11361-1429
- **Practice address phone:** (718) 631-7800
- **Practice address fax:** (718) 631-4949
- **Mailing address:** 20920 35TH AVE, BAYSIDE, NY 11361-1429
- **Mailing address phone:** (718) 631-7800
- **Mailing address fax:** (718) 631-4949

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | — | — | Yes |
| 1223P0300X | Periodontics | — | — | — |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 09/11/2025