Healthcare Provider Details

I. General information

NPI: 1427976117
Provider Name (Legal Business Name): LI ORTHODONTICS NASSAU PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 STEWART AVE STE 308
WESTBURY NY
11590-6611
US

IV. Provider business mailing address

1600 STEWART AVE STE 308
WESTBURY NY
11590-6611
US

V. Phone/Fax

Practice location:
  • Phone: 857-264-7045
  • Fax:
Mailing address:
  • Phone: 857-264-7045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. LOK CHING LI
Title or Position: SHAREHOLDER
Credential: DMD, MSD
Phone: 857-264-7045