PREMIER ENDODONTICS OF PATCHOGUE (NPI# 1184115859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184115859 |
| Entity Type | Organization |
| Organization Name | PREMIER ENDODONTICS OF PATCHOGUE |
| Practice Address |
44 Medford Avenue Patchogue NY 11772 |
| Practice Telephone | 6314476060 |
| Practice Fax Number | 6314477088 |
| Mailing Telephone | 6314476060 |
| Mailing Fax Number | 6314477088 |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2018-05-31 |
| Authorized Official Name | DR. ASHISH SAHASRABUDHE (OWNER) |
| Authorized Official Telephone | 5162221822 |
| Authorized Official Credential | D.M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
NY | Dental Providers | |
| N | 1223P0300X |
Dentist Specialization: Periodontics |
NY | Dental Providers | |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
NY | Dental Providers |
| Street Address |
44 MEDFORD AVENUE |
| City | PATCHOGUE |
| State | NY |
| Zip Code | 11772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447224 | Amita Vipul Patel | Nurse Practitioner | Longlsland Community Hospital, 101 Hospital Rd, Patchogue, NY 11772 | 2020-08-13 |
| 1609491968 | Sanjib Dey | Family Medicine | Brookhaven Nephrology Associates, 260 E. Patchogue-yaphank Rd., Patchogue, NY 11772 | 2020-06-12 |
| 1992297204 | Camila Bueno-sanchez | Student in an Organized Health Care Education/Training Program | 676 S Country Rd, East Patchogue, NY 11772 | 2018-06-01 |
| 1801386453 | Franklin Ikechukwu Ugbode | Student in an Organized Health Care Education/Training Program | 100 Hospital Road Suite 201, Patchogue, NY 11772 | 2018-05-18 |
| 1508372335 | Stephanie Vanschaick | Counselor | 450 Waverly Ave Ste 11, Patchogue, NY 11772 | 2017-12-15 |
| 1578074498 | Chrystal Lee Curran | Specialist | 1116 Main Road, Aquebogue, NY 11772 | 2017-10-18 |
| 1013457712 | Candyce Fahner | Registered Nurse | 22 Haig Ave, E Patchogue, NY 11772 | 2017-02-28 |
| 1992251631 | Vanessa Lynn Petoello | Nurse Practitioner | 107 N/ Ocean Ave, Suite G, Patchogue, NY 11772 | 2016-09-01 |
| 1811343809 | Andrew Vanderlofske | Nurse Practitioner | 144 North Ocean Avenue, Patchogue, NY 11772 | 2016-05-09 |
| 1578917431 | Pricilla A Vasquez | Licensed Practical Nurse | 260 Waverly Ave Apt 26, Patchogue, NY 11772 | 2016-04-18 |
| Find all providers in zip 11772 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609077494 | Suffolk Endodontics | Dentist | 70 Medford Ave, Patchogue, NY 11772-1202 | 2007-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026235 | Sanghyun Park | Dentist | 1103 Stewart Ave Ste 104, Garden City, NY 11530-4886 | 2020-09-03 |
| 1164031654 | Harp Endodontics PC | Dentist | 121 E 60th St Apt 10a, New York, NY 10022-1198 | 2020-07-30 |
| 1518590918 | All County Endodontics, PC | Dentist | 112 Westminster Rd, Scarsdale, NY 10583-2425 | 2020-02-14 |
| 1245862325 | Marie Milagros Mora Moreno | Dentist | 345 E 24th St Dept Of, New York, NY 10010-4020 | 2020-02-06 |
| 1407406218 | Geoffrey Louis Sas | Dentist | 1414 Avenue of The Americas Fl 19, New York, NY 10019-2514 | 2019-09-13 |
| 1790340875 | Kim & Wang Dds Pllc | Dentist | 10737 71st Ave Ste 203, Forest Hills, NY 11375-4736 | 2019-05-05 |
| 1003373903 | Prohealth Dental Pllc | Dentist | 5011 Vernon Blvd, Long Island City, NY 11101 | 2019-02-27 |
| 1023575982 | Prohealth Dental Pllc | Dentist | 16345 Crossbay Blvd, Howard Beach, NY 11414-3741 | 2019-02-27 |
| 1114494911 | Alf Hitel Bunes | Dentist | 900 Starboard Side Ln Apt 306, Webster, NY 14580-2288 | 2018-10-30 |
| 1972086684 | Steven Kyongmin Kim | Dentist | 209 E 56th St Frnt 1, New York, NY 10022 | 2018-09-09 |
| Find all providers with the same taxonomy | ||||
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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.