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Organization

MT. SINAI FAMILY DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ANTOINETTE DERENZO (OFFICE MANAGER)
(631) 331-8989
Entity
Organization

Contact information

Practice address
5505 NESCONSET HWY, STE. 230, MOUNT SINAI, NY 11766-2037
(631) 331-8989
(631) 331-7962
Mailing address
5505 NESCONSET HWY, STE. 230, MOUNT SINAI, NY 11766-2037
(631) 331-8989
(631) 331-7962

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
047118
NY
1223G0001X
General Practice Dentistry
047078
NY
1223G0001X
General Practice Dentistry
048342
NY

Other

Enumeration date
05/25/2007
Last updated
09/11/2025
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