Healthcare Provider Details

I. General information

NPI: 1578258067
Provider Name (Legal Business Name): 400 POST DENTAL, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 POST AVE STE 103
WESTBURY NY
11590-2226
US

IV. Provider business mailing address

308 MAIN ST APT D
ROSLYN NY
11576-2109
US

V. Phone/Fax

Practice location:
  • Phone: 516-515-1041
  • Fax:
Mailing address:
  • Phone: 718-724-3126
  • 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: DR. TONYA BELLAMY-BISSOON
Title or Position: DENTIST
Credential: DDS
Phone: 516-515-1041