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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ROOSEVELT FIELD MALL DENTAL PC

Active Organization

ROOSEVELT FIELD MALL DENTAL PC is a Periodontology organization located in GARDEN CITY, New York. NPI 1073638151 is currently active in the NPPES registry. Verify at CMS.

Periodontology · GARDEN CITY, NY

Registration Details

NPI Number
1073638151
Provider Type
Organization
NPI Issued
Mar 20, 2007 (19.429744957424 yrs)
Last Updated
Sep 11, 2025

Practice Information

Address
630 OLD COUNTRY ROAD
GARDEN CITY, NY, 11530
Browse NY providers · Browse ZIP 11530
Phone
5162941919
Fax
5162946219
Primary Specialty
Periodontology
1223P0300X
Additional Specialty
Periodontology
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.