Healthcare Provider Details

I. General information

NPI: 1609701853
Provider Name (Legal Business Name): MATT NOURMAND DENTAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 WHEATLEY RD
OLD WESTBURY NY
11568-1210
US

IV. Provider business mailing address

91 WHEATLEY RD
OLD WESTBURY NY
11568-1210
US

V. Phone/Fax

Practice location:
  • Phone: 516-222-0493
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW NOURMAND
Title or Position: OWNER
Credential: DMD
Phone: 516-450-7199