Organization
PROHEALTH DENTAL PLLC
Active
Parent organization
PROHEALTH DENTAL PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROHEALTH DENTAL PLLC
Authorized official
NATALYA KOROBEYNYK (RCM)
(516) 654-4400
Entity
Organization
Contact information
Practice address
1 PRO HEALTH PLZ, SUITE 115, NEW HYDE PARK, NY 11042
(516) 467-8191
(516) 467-8192
Mailing address
3333 NEW HYDE PARK RD STE 310, NEW HYDE PARK, NY 11042-1205
(516) 654-4400
(516) 467-8192
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
055531
NY
1223G0001X
General Practice Dentistry
042857
NY
1223G0001X
General Practice Dentistry
057838
NY
1223P0221X
Pediatric Dentistry
053382
NY
1223P0221X
Pediatric Dentistry
055400
NY
1223P0300X
Periodontics
Primary
037989
NY
1223P0700X
Prosthodontics
037623
NY
1223P0700X
Prosthodontics
043834
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
036753
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
049846
NY
Other
Enumeration date
10/07/2015
Last updated
12/13/2021
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