DR. JAMES PEZZOLLO (NPI# 1184081960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184081960 |
| Entity Type | Individual |
| Full Name | DR. JAMES PEZZOLLO |
| Credential | DMD |
| Practice Address |
601 Franklin Ave Ste 110 Garden City NY 11530-5760 |
| Practice Telephone | 5162749979 |
| Mailing Telephone | 5162749979 |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2020-08-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
061142 | NY | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2035 Lakeville Rd Ste 204, New Hyde Park, NY 110401661 | 5165634106 | |
| 23 Bond St Ste 8, Great Neck, NY 110212025 | 5163001750 | |
| 3706 82nd St Ste 304, Jackson Heights, NY 113727017 | 3473540609 |
| Street Address |
601 FRANKLIN AVE STE 110 |
| City | GARDEN CITY |
| State | NY |
| Zip Code | 11530-5760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144850207 | Ellen Jay Palacio Mabatid | Physical Therapist | 66 New Hyde Park, Garden City, NY 11530 | 2020-01-16 |
| 1255991022 | Rubin Anesthesia Pain Management, Pllc | Anesthesiology | 1103 Stewart Avenue, Suite 300, Garden City, NY 11530 | 2019-06-14 |
| 1144793720 | Jack Doby Garden City, LLC | Eyewear Supplier (Equipment, not the service) | Jack Doby Garden City, LLC, 928 Old Country Road, Garden City, NY 11530 | 2019-01-07 |
| 1386135051 | Granger & Sahasra | Dentist | 1103 Stewart Avenue Suite 104, Garden City, NY 11530 | 2018-05-29 |
| 1598262537 | Suzanne P. Reid-bradshaw | Specialist | Kidz Therapy, 300 Garden City Plaza, Garden City, NY 11530 | 2018-04-06 |
| 1972021129 | Nicole Maria Gaudino | Nurse Practitioner | One South Avenue, Waldo Hall, Garden City, NY 11530 | 2017-09-07 |
| 1619495645 | Christine Scheppa | Registered Nurse | 225 Brompton Rd South, Garden City South, NY 11530 | 2017-08-30 |
| 1699290981 | Deborah Ann Pontosky | Registered Nurse | 104 Fifth Street, Garden City, NY 11530 | 2017-08-08 |
| 1932648748 | Tahmina Jahir | Student in an Organized Health Care Education/Training Program | 15 Hilton Ave, Garden City, NY 11530 | 2017-02-14 |
| 1598209173 | Dino Michelli | Specialist | 300 Garden City Plaza, Ste 350, Kidz Therapy/ Gayle E. Kligman Therapeutic Resources, Garden City, NY 11530 | 2016-12-15 |
| Find all providers in zip 11530 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629057088 | Ronald L. Roholt | Dentist | 311 Campus Drive, Suite 101, Garden City, KS 67846 | 2006-01-13 |
| 1508195975 | Rodney Rastegar Dds Pllc | Dentist | 601 Franklin Ave, Suite 110, Garden City, NY 11530 | 2009-12-15 |
| 1265625537 | Petros Panagos | Dentist | 601 Franklin Ave, Suite 101, Garden City, NY 11530-5795 | 2007-08-21 |
| 1275672578 | Louie F. Peede Jr. | Dentist | 801 North Main Street, Garden City, KS 67846 | 2007-02-05 |
| 1063503670 | Eugene P Pezzollo | Dentist | 601 Franklin Ave, St 110, Garden City, NY 11530-5795 | 2006-09-27 |
| 1982795506 | Rodney Rastegar | Dentist | 601 Franklin Ave, St 210, Garden City, NY 11530-5795 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053921643 | Upper West Side Oral & Maxillofacial Surgery | Dentist | 140 W 69th St Ph 1g, New York, NY 10023-5173 | 2020-08-07 |
| 1467092965 | Nyc Implant and Oral Surgery PC | Dentist | 30 E 60th St Ste 907, New York, NY 10022-1058 | 2020-01-13 |
| 1235777566 | Asnis Dental Pllc | Dentist | 800 Woodbury Rd Ste C, Woodbury, NY 11797-2503 | 2019-12-17 |
| 1700420429 | Chavkin Oral and Maxillofacial Surgery LLC | Dentist | 414 Jericho Tpke Ste 2, New Hyde Park, NY 11040-4510 | 2019-11-06 |
| 1730737545 | Southwoods Boulevard Dental, P.C. | Dentist | 7 Southwoods Blvd Ste 1, Albany, NY 12211-2526 | 2019-08-27 |
| 1750947792 | Eduard Munarov Dds PC | Dentist | 449 N State Rd Ste 102, Briarcliff Manor, NY 10510-1478 | 2019-05-15 |
| 1598227530 | Asnis Dental Pllc | Dentist | 250 Patchogue Yaphank Rd Ste 10, East Patchogue, NY 11772-4862 | 2019-04-01 |
| 1720545387 | Asnis Dental, Pllc | Dentist | 260 Middle Country Rd Ste 12, Selden, NY 11784-2570 | 2019-03-01 |
| 1205344819 | Ray Cheng Dds | Dentist | 217 Park Row Ste 4b, New York, NY 10038-1101 | 2018-01-17 |
| 1871006064 | Ny Oral and Maxillofacial Surgeon, PC | Dentist | 2844 Ocean Pkwy Ste B2, Brooklyn, NY 11235-7904 | 2017-11-09 |
| Find all providers with the same taxonomy | ||||
| City | GARDEN CITY |
| Zip Code | 11530 |
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| 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.