Healthcare Provider Details

I. General information

NPI: 1285818195
Provider Name (Legal Business Name): JOHN FRANKIS DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 GLEN ST
GLEN COVE NY
11542-2704
US

IV. Provider business mailing address

25 GLEN ST
GLEN COVE NY
11542-2704
US

V. Phone/Fax

Practice location:
  • Phone: 516-676-1300
  • Fax: 516-676-1363
Mailing address:
  • Phone: 516-676-1300
  • Fax: 516-676-1363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number048332
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number053560
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number051773
License Number StateNY

VIII. Authorized Official

Name: DR. JOHN S FRANKIS
Title or Position: OWNER
Credential: DDS
Phone: 516-676-1300