MEDICARE: HUNTINGTON DENTAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1033054002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNTINGTON DENTAL GROUP

Provider Business Mailing Address
First Line	:	690 NEW YORK AVE
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-4236
Country	:	US
Telephone Number	:	917-251-6262
Fax Number	:

Provider Business Practice Location Address
First Line	:	690 NEW YORK AVE
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-4236
Country	:	US
Telephone Number	:	917-251-6262
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/GENERAL DENTIST
Name	:	TASSOS KATECHIS
Credential	:	DDS
Telephone Number	:	646-236-2400

Provider Enumeration Date	:	04/23/2026
Last Update Date	:	04/23/2026

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Directions to “HUNTINGTON DENTAL GROUP ” Practice Location

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