Healthcare Provider Details

I. General information

NPI: 1427682913
Provider Name (Legal Business Name): ASNIS DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2020
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 OLD COUNTRY RD
PLAINVIEW NY
11803-5019
US

IV. Provider business mailing address

135 PINELAWN RD STE 150S
MELVILLE NY
11747-3187
US

V. Phone/Fax

Practice location:
  • Phone: 516-931-7171
  • Fax: 631-396-0452
Mailing address:
  • Phone: 631-414-7927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: HIRO SORIANO
Title or Position: CIO
Credential:
Phone: 516-344-5746