Healthcare Provider Details

I. General information

NPI: 1215806658
Provider Name (Legal Business Name): ORAL AND FACIAL SURGERY OF QUEENS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8520 ELMHURST AVE
ELMHURST NY
11373-3351
US

IV. Provider business mailing address

8520 ELMHURST AVE
ELMHURST NY
11373-3351
US

V. Phone/Fax

Practice location:
  • Phone: 718-426-1212
  • Fax:
Mailing address:
  • Phone: 718-426-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: YAAKOV ALLAEB
Title or Position: OWNER
Credential: D.D.S
Phone: 646-546-2276