MOHEGAN LAKE DENTAL PC (NPI# 1164974853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164974853 |
| Entity Type | Organization |
| Organization Name | MOHEGAN LAKE DENTAL PC |
| Practice Address |
1719 E Main St Mohegan Lake NY 10547-1356 |
| Practice Telephone | 9145282191 |
| Practice Fax Number | 9147431579 |
| Mailing Telephone | 9145282191 |
| Mailing Fax Number | 9147431579 |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |
| Authorized Official Name | DR. OJAS V. SHAH (OWNER/PRESIDENT) |
| Authorized Official Telephone | 9143101609 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
0556901 | NY | Ambulatory Health Care Facilities |
| Street Address |
1719 E MAIN ST |
| City | MOHEGAN LAKE |
| State | NY |
| Zip Code | 10547-1356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447530969 | Ojas V Shah | Dentist | 1719 E Main St, Mohegan Lake, NY 10547-1356 | 2011-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740732965 | Nancy Messenger | Registered Nurse | 602 Panorama Drive, Mohegan Lake, NY 10547 | 2016-11-04 |
| 1245606532 | Acme Markets Inc | Durable Medical Equipment & Medical Supplies | 3071 E Main St, Mohegan Lake, NY 10547 | 2015-08-20 |
| 1780960427 | Bernadette Ann Coyne | Speech-Language Pathologist | 3641 Cooper Street, Mohegan Lake, NY 10547 | 2011-10-26 |
| 1821389487 | Albert Wilhelm Perez | Physical Therapy Assistant | 3550 Mohegan Lake, Mohegan Lake, NY 10547 | 2011-04-29 |
| 1437470853 | Ingrid N. Hiller | Licensed Practical Nurse | 100 Sunfish Landing, Mohegan Lake, NY 10547 | 2010-06-21 |
| 1447573449 | Kenneth Evan Strauss | Pharmacist | 1775 East Main Street, Mohegan Lake, NY 10547 | 2010-03-04 |
| 1841444569 | Patricia Ann Marcus | Physical Therapist | 1573 Wenonah Trail, Mohegan Lake, NY 10547 | 2008-11-07 |
| 1104965771 | Shoprite Supermarkets, Inc | Pharmacy | 3140 E Main St Ste 300, Mohegan Lake, NY 10547 | 2007-02-06 |
| 1710051198 | Samuel Ross Gambino | Dentist | Rt.6 East Main Street, Mohegan Lake, NY 10547 | 2006-11-20 |
| 1639132905 | Mohegan Volunteer Fire Association Volunteer Ambulance Corps Inc | Ambulance | 1975 East Main St, Mohegan Lake, NY 10547 | 2006-04-08 |
| Find all providers in zip 10547 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699380246 | Charles R Hoeg Dmd PC | Clinic/Center | 45 Route 25a Ste A1, Shoreham, NY 11786-1389 | 2020-09-10 |
| 1801409016 | Daniel Babadzhanov Dmd Pllc | Clinic/Center | 7025 Yellowstone Blvd Ste 1o, Forest Hills, NY 11375-3165 | 2020-08-26 |
| 1417567611 | Hudson River Dental | Clinic/Center | 1 Baltic Pl Ste 104, Croton On Hudson, NY 10520-1642 | 2020-08-03 |
| 1316556897 | Bridget E. Sweeney, Dds, Pllc | Clinic/Center | 6043 Transit Road, Suite 102, Clarence, NY 14031 | 2020-07-30 |
| 1679182919 | Avalon Dental, PC | Clinic/Center | 20103 Northern Blvd Fl 1, Flushing, NY 11361-2563 | 2020-07-22 |
| 1104442706 | Igor Dekhkanov Dds PC | Clinic/Center | 438 Graham Ave Fl 1, Brooklyn, NY 11211-1415 | 2020-06-19 |
| 1245852334 | Walter G Neuhaus Dds PC | Clinic/Center | 2825 Niagara Falls Blvd Ste 170, Amherst, NY 14228-2000 | 2020-05-12 |
| 1487274445 | Rock A Smile Dental Studio Pllc | Clinic/Center | 9708 Rockaway Blvd, Ozone Park, NY 11417-1615 | 2020-04-20 |
| 1033738414 | Samina Haque Dmd Pllc | Clinic/Center | 25012 Hillside Ave Ste A, Bellerose, NY 11426-2139 | 2020-04-15 |
| 1366077844 | New York Dental Care, Pllc | Clinic/Center | 124 E 40th St Rm 302, New York, NY 10016-1723 | 2020-03-05 |
| Find all providers with the same taxonomy | ||||
| City | MOHEGAN LAKE |
| Zip Code | 10547 |
Please comment or provide details below to improve the information on MOHEGAN LAKE DENTAL PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.