Healthcare Provider Details

I. General information

NPI: 1366783607
Provider Name (Legal Business Name): CATHERINE DURANTE DMD, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2013
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 MIDDLE COUNTRY RD STE 1
SELDEN NY
11784-3314
US

IV. Provider business mailing address

600 N WELLWOOD AVE STE D
LINDENHURST NY
11757
US

V. Phone/Fax

Practice location:
  • Phone: 516-314-1783
  • Fax:
Mailing address:
  • Phone: 631-225-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number061647
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: