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104 DENTAL, PLLC
NPI 1104356476
Dentist - General Practice in Corona, NY

Active since June 19, 2017
10423 ROOSEVELT AVENUE, CORONA, NY 11368(718) 426-3000(718) 426-3002 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Jun 3, 2019, Jun 19, 2017 (3 updates tracked since 2017).

About 104 Dental, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

104 DENTAL, PLLC (NPI 1104356476) is a healthcare organization registered as a general practice in Corona, New York and active in the NPI registry since June 2017. The organization lists Artin Sakhaee, Owner, as its authorized official.

NPPES Registry Identity

NPI1104356476
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business Name104 DENTAL, PLLC
Location Address10423 ROOSEVELT AVENUECorona, NY 11368-2327
Mailing Address10423 Roosevelt AvenueCorona, NY 11368-2327 · (718) 426-3000 · Fax (718) 426-3002
Phone(718) 426-3000
Fax(718) 426-3002
Organization SubpartNo
Authorized OfficialArtin SakhaeeOwner · (718) 476-7801
Enumeration DateJune 19, 2017
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1104356476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NY · 052701
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
10423 ROOSEVELT AVENUE, Corona, NY 11368
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Other Identifiers 1

Medicaid052701NY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 104 Dental, PLLC's NPI number?

The NPI number for 104 Dental, PLLC is 1104356476. It was assigned to this organization in the NPPES registry on June 19, 2017.

Where is 104 Dental, PLLC located?

104 Dental, PLLC is located at 10423 Roosevelt Avenue, Corona, NY 11368. The listed phone number is (718) 426-3000.

What is 104 Dental, PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does 104 Dental, PLLC accept?

Health plans from UnitedHealthcare list 104 Dental, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for 104 Dental, PLLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.