Healthcare Provider Details

I. General information

NPI: 1285557827
Provider Name (Legal Business Name): LONG ISLAND SMILE DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 GLEN COVE RD
ROSLYN HEIGHTS NY
11577-1718
US

IV. Provider business mailing address

120 GLEN COVE RD
ROSLYN HEIGHTS NY
11577-1718
US

V. Phone/Fax

Practice location:
  • Phone: 516-621-1788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SETH NEWMAN
Title or Position: DOCTOR
Credential:
Phone: 732-636-3900