LONG ISLAND ORAL & MAXILLOFACIAL SURGERY, PC
NPI 1710060223
Dentist - Oral and Maxillofacial Surgery in Port Washington, NY
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
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Long Island Oral & Maxillofacial Surgery, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Long Island Oral & Maxillofacial Surgery, PC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, NYFrequently 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.
Is Long Island Oral & Maxillofacial Surgery, PC enrolled in Medicare?
Yes. Long Island Oral & Maxillofacial Surgery, PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Long Island Oral & Maxillofacial Surgery, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Long Island Oral & Maxillofacial Surgery, PC, in Maxillofacial Surgery and Oral Surgery. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Long Island Oral & Maxillofacial Surgery, Pc · NPI 1710060223
Oral and Maxillofacial Surgery organization in Port Washington, New York. Organization record, active in the CMS NPPES registry since October 20, 2006.
## Identity
- **NPI:** 1710060223 (Entity type: Organization)
- **Enumerated:** October 20, 2006
- **Primary specialty:** Dentist - Oral and Maxillofacial Surgery · taxonomy 1223S0112X
- **Organization subpart:** Yes (part of Long Island Oral & Maxillofacial Surgery, Pc)
- **Authorized official:** Debra Mcquillan, MANAGER
## Practice location
- **Address:** 14 VANDERVENTER AVE, STE 260, Port Washington, NY 11050-3737
- **Phone:** (516) 944-8330 · **Fax:** (516) 883-1598
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Maxillofacial Surgery (2), Oral Surgery (2); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 11, 2008
- **Other identifiers:** Medicare PIN D0W062 (NY)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1710060223) · Data from the CMS NPPES public registry.