Provider Demographics
NPI:1407685043
Name:VILLAGE DENTISTRY PLLC
Entity type:Organization
Organization Name:VILLAGE DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PREMINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:516-481-1446
Mailing Address - Street 1:11055 72ND RD STE L1
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5420
Mailing Address - Country:US
Mailing Address - Phone:718-618-6294
Mailing Address - Fax:718-263-0701
Practice Address - Street 1:11055 72ND RD STE L1
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5420
Practice Address - Country:US
Practice Address - Phone:718-618-6294
Practice Address - Fax:718-263-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty