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General NPI Number Information
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NPI Number | 1154275923
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Entity Type | Organization
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Legal Business Name | SAME DAY SMILES OF COMMACK
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Dates
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Enumeration Date | 02/26/2026
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Last Update Date | 02/26/2026
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Provider Practice Location Address
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Address Line | 164 COMMACK RD
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City | COMMACK
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State | NY
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Zip | 11725-3430
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Country | US
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Telephone | 516-749-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 164 COMMACK RD STE 2
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City | COMMACK
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State | NY
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Zip | 11725-3430
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Country | US
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Telephone | 516-749-3000
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Fax |
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Authorized Official
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Title or Position | SURGEON
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Name | STEVE YUSUPOV
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Credential | DDS, MD
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Telephone | 516-749-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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