Healthcare Provider Details

I. General information

NPI: 1851238687
Provider Name (Legal Business Name): CLT DENTISTRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6254 97TH PL STE 2A
REGO PARK NY
11374-1354
US

IV. Provider business mailing address

6254 97TH PL STE 2A
REGO PARK NY
11374-1354
US

V. Phone/Fax

Practice location:
  • Phone: 718-592-2207
  • Fax: 718-592-8713
Mailing address:
  • Phone: 718-592-2207
  • Fax: 718-592-8713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. CRAIG L. TISCHLER
Title or Position: DENTIST/OWNER
Credential: D.D.S.
Phone: 718-592-2207