Provider Demographics
NPI:1386061083
Name:DENTAL IMPLANT SOLUTIONS OF NEW YORK
Entity type:Organization
Organization Name:DENTAL IMPLANT SOLUTIONS OF NEW YORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-565-6565
Mailing Address - Street 1:639 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-4334
Mailing Address - Country:US
Mailing Address - Phone:516-565-5656
Mailing Address - Fax:516-565-3391
Practice Address - Street 1:639 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-4334
Practice Address - Country:US
Practice Address - Phone:516-565-5656
Practice Address - Fax:516-565-3391
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ISLAND DENTAL ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY439351223G0001X
NY527721223P0300X
NY398881223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty