MEDICARE: FARMINGDALE DENTAL GROUP PC

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	:	1851225379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARMINGDALE DENTAL GROUP PC

Provider Business Mailing Address
First Line	:	260 MERRITTS RD
Second Line	:
City	:	FARMINGDALE
State	:	NY
Zip	:	11735-3267
Country	:	US
Telephone Number	:	516-249-4206
Fax Number	:	516-249-8141

Provider Business Practice Location Address
First Line	:	260 MERRITTS RD
Second Line	:
City	:	FARMINGDALE
State	:	NY
Zip	:	11735-3267
Country	:	US
Telephone Number	:	516-249-4206
Fax Number	:	516-249-8141

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHARLES AXELRAD
Credential	:	DDS
Telephone Number	:	631-327-3647

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “FARMINGDALE DENTAL GROUP PC ” Practice Location

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