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General NPI Number Information
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NPI Number | 1013871573
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Entity Type | Organization
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Legal Business Name | PEDIATRIC DENTISTRY COMMUNITY DRIVE GREAT NECK PC
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 225 COMMUNITY DR STE 170
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City | GREAT NECK
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State | NY
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Zip | 11021-5503
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Country | US
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Telephone | 516-231-8480
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Fax | 516-231-9164
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Provider Business Mailing Address
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Address Line | 225 COMMUNITY DR STE 170
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City | GREAT NECK
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State | NY
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Zip | 11021-5503
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Country | US
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Telephone | 516-231-8480
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Fax | 516-231-9164
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT NEAL GOLDSMITH
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Credential | DMD
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Telephone | 860-670-4459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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