LONG ISLAND ORAL & MAXILLOFACIAL SURGERY, PC - NPI 1710060223

Q: What is Long Island Oral & Maxillofacial Surgery, PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

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About Long Island Oral & Maxillofacial Surgery, Pc NPPES

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

LONG ISLAND ORAL & MAXILLOFACIAL SURGERY, PC (NPI 1710060223) is a healthcare organization registered as an oral and maxillofacial surgery in Port Washington, New York and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through September 22, 2027 and lists Debra Mcquillan, Manager, as its authorized official.

NPPES Registry Identity

NPI1710060223

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameLONG ISLAND ORAL & MAXILLOFACIAL SURGERY, PC

Location Address14 VANDERVENTER AVE, STE 260Port Washington, NY 11050-3737

Mailing Address14 Vanderventer Ave, Ste 260Port Washington, NY 11050-3737 · (516) 944-8330 · Fax (516) 883-1598

Phone(516) 944-8330

Fax(516) 883-1598

Organization SubpartYes

Authorized OfficialDebra McquillanManager · (516) 294-9696

Enumeration DateOctober 20, 2006

Last NPPES UpdateJanuary 11, 2008

✔ NPI 1710060223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

14 VANDERVENTER AVE, Port Washington, NY 11050

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Other Identifiers 1

Medicare PIND0W062NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D1105475

Long Island Oral & Maxillofacial Surgery, PC · Mineola, NY

Active · expires Sep 22, 2027

CLIA Number33D1105475

Laboratory TypePhysician Office

Certificate Effective DateSeptember 23, 2025

Certificate Expiration DateSeptember 22, 2027

Laboratory DirectorDr. Scott A. Fauvell

Laboratory Phone(516) 294-9696

Laboratory LocationLong Island Oral & Maxillofacial Surgery, PC134 Mineola Blvd Suite 302, Mineola, NY 11501

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SUSAN VIVIAN JACOB PHD

Psychologist (Clinical Child & Adolescent)

14 VANDERVENTER AVE
PORT WASHINGTON, NY 11050

Nassau County (516) 944-3786

DR. PAUL DOMINIC VERDI DDS

Dentist (General Practice)

14 VANDERVENTER AVE, SUITE 140
PORT WASHINGTON, NY 11050

Nassau County (516) 767-3353

DR. DANIELA SPECTOR D.D.S

Dentist

14 VANDERVENTER AVE, SUITE 120
PORT WASHINGTON, NY 11050

Nassau County (516) 883-0584

DR. RHONDA MAE YOSS-KAPLAN PSY.D

Psychologist (Clinical Child & Adolescent)

14 VANDERVENTER AVE, SUITE 103
PORT WASHINGTON, NY 11050

Nassau County (516) 767-8180

MS. ROBIN PERLBERG L.AC.

Acupuncturist

14 VANDERVENTER AVE, SUITE 145
PORT WASHINGTON, NY 11050

Nassau County (516) 316-7821

ROBERT STEVEN POPKIN DMD MAGD

Dentist (General Practice)

14 VANDERVENTER AVE
PORT WASHINGTON, NY 11050

Nassau County (516) 767-3658

DR. ANITA E SHASHOUA DDS

Dentist

14 VANDERVENTER AVE, SUITE 212
PORT WASHINGTON, NY 11050

Nassau County (516) 802-4141

DR. ASHRAF M ESTAFAN DDS

Dentist (Prosthodontics)

14 VANDERVENTER AVE, SUITE 215
PORT WASHINGTON, NY 11050

Nassau County (516) 883-6199

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 Long Island Oral & Maxillofacial Surgery, PC's NPI number?

The NPI number for Long Island Oral & Maxillofacial Surgery, PC is 1710060223. It was assigned to this organization in the NPPES registry on October 20, 2006.

Where is Long Island Oral & Maxillofacial Surgery, PC located?

Long Island Oral & Maxillofacial Surgery, PC is located at 14 Vanderventer Ave Ste 260, Port Washington, NY 11050. The listed phone number is (516) 944-8330.

What is Long Island Oral & Maxillofacial Surgery, PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Does Long Island Oral & Maxillofacial Surgery, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D1105475) is associated with this NPI, valid through September 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Long Island Oral & Maxillofacial Surgery, PC was last updated on January 11, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.