Healthcare Provider Details

I. General information

NPI: 1245174317
Provider Name (Legal Business Name): ALIZA B GETTENBERG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17411 HORACE HARDING EXPY
FRESH MEADOWS NY
11365-1527
US

IV. Provider business mailing address

388 KENRIDGE RD
LAWRENCE NY
11559-1816
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-1060
  • Fax:
Mailing address:
  • Phone: 516-941-7791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: