Jpda Dental Services PLLC
Clinic/Center, Dental in Freeport, NY. Organization (NPI-2).
NPI number1063257905
StatusActive
Last updated in NPPESJul 1, 2024
Details
- NPI
- 1063257905
- Entity type
- Organization (NPI-2)
- Legal business name
- Jpda Dental Services PLLC
- Organization subpart
- No
- Enumeration date
- Jul 1, 2024
- Certification date
- Jul 1, 2024
- Last updated
- Jul 1, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Iconic Smiles Of Freeport (Doing Business As)
Practice location
268 W Merrick RdFreeport, NY 11520-3347
Phone 516-378-3200
Mailing address
268 W Merrick RdFreeport, NY 11520-3347
Phone 516-378-3200
Authorized official
Jacob J Pleshty
Co-Owner
6468750223
Is something wrong?
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