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General NPI Number Information
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NPI Number | 1699638262
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Entity Type | Organization
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Legal Business Name | GRACEFUL DENTAL PLLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 3625 UNION ST STE C
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City | FLUSHING
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State | NY
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Zip | 11354-4166
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Country | US
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Telephone | 718-539-5306
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Fax | 718-539-0410
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Provider Business Mailing Address
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Address Line | 3625 UNION ST STE C
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City | FLUSHING
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State | NY
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Zip | 11354-4166
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Country | US
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Telephone | 718-539-5306
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Fax | 718-539-0410
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | GRACE FENG
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Credential | DDS
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Telephone | 516-297-7336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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