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General NPI Number Information
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NPI Number | 1578684866
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Entity Type | Organization
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Legal Business Name | RALLIS DENTISTRY OF BAYSIDE,PLLC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 20920 35TH AVE
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City | BAYSIDE
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State | NY
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Zip | 11361-1429
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Country | US
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Telephone | 718-631-7800
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Fax | 718-631-4949
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Provider Business Mailing Address
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Address Line | 20920 35TH AVE
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City | BAYSIDE
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State | NY
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Zip | 11361-1429
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Country | US
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Telephone | 718-631-7800
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Fax | 718-631-4949
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Authorized Official
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Title or Position | MEMBER
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Name | DR. NICHOLAS I. RALLIS
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Credential | D.D.S.
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Telephone | 718-631-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number |
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License Number State |
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