MEDICARE: GENERAL DENTISTRY OF STATEN ISLAND PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1689531139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENERAL DENTISTRY OF STATEN ISLAND PLLC

Provider Business Mailing Address
First Line	:	2936 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-4056
Country	:	US
Telephone Number	:	718-987-6453
Fax Number	:	718-980-4588

Provider Business Practice Location Address
First Line	:	2936 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-4056
Country	:	US
Telephone Number	:	718-987-6453
Fax Number	:	718-980-4588

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	DR. NICHOLAS ANTHONY DIAZ
Credential	:	DDS
Telephone Number	:	718-987-6453

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

Similar Medicare Providers

1720025000 — OAKWOOD DENTAL, P.C.
Practice Location Address:

2936 HYLAN BLVD
STATEN ISLAND, NY
10306-4056

Practice Phone: 718-987-6453
Practice Fax: 718-980-4588

1417173535 — SANDRA LISA KAPLAN D.D.S.
Practice Location Address:

2936 HYLAN BLVD
STATEN ISLAND, NY
10306-4056

Practice Phone: 718-987-6453
Practice Fax: 718-980-4588

1154547289 — ALLEN I GRAFSTEIN D.D.S.
Practice Location Address:

2936 HYLAN BLVD
STATEN ISLAND, NY
10306-4056

Practice Phone: 718-987-6453
Practice Fax: 718-980-4588

1265898662 — ROBERT MINLIONICA DC, ATC
Practice Location Address:

2950 HYLAN BLVD STE 100
STATEN ISLAND, NY
10306-4056

Practice Phone: 718-874-6002
Practice Fax:

1780044529 — DR. NICHOLAS ANTHONY DIAZ DDS
Practice Location Address:

2936 HYLAN BLVD
STATEN ISLAND, NY
10306-4056

Practice Phone: 718-987-6453
Practice Fax:

1437962149 — STATEN ISLAND CHIROPRACTIC & SPORTS REHAB P.C.
Practice Location Address:

2950 HYLAN BLVD STE 100
STATEN ISLAND, NY
10306-4056

Practice Phone: 718-874-6002
Practice Fax: 718-874-6005

Directions to “GENERAL DENTISTRY OF STATEN ISLAND PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.