Healthcare Provider Details

I. General information

NPI: 1346863404
Provider Name (Legal Business Name): JAMES ANTHONY PRIFTAKIS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2020
Last Update Date: 09/29/2026
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1036 W JERICHO TPKE
SMITHTOWN NY
11787-3208
US

IV. Provider business mailing address

1036 W JERICHO TPKE
SMITHTOWN NY
11787-3208
US

V. Phone/Fax

Practice location:
  • Phone: 631-543-4433
  • Fax:
Mailing address:
  • Phone: 631-543-4433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number062202
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: