OrganizationActive
Roosevelt Field Mall Dental PC
NPI 1073638151 · Periodontics · Garden City, NY
Roosevelt Field Mall Dental PC is a Periodontics organization in Garden City, NY (NPI 1073638151).
Provider details
- NPI number
- 1073638151
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Organization subpart
- No
- Authorized official
- Alexander Mikhailov, Owner(516) 294-1919
Specialties & taxonomies
Dental Providers
- General Practice Dentistry1223G0001X
Dental Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
630 Old Country Road
Garden City, NY 11530
Phone: (516) 294-1919
Fax: (516) 294-6219
Approximate (ZIP-level) locationGet directions
Mailing address
630 Old Country Road
Garden City, NY 11530
Registry dates
- Enumerated
- 2007-03-20
- Last updated
- 2025-09-11
Frequently asked questions
- What is Roosevelt Field Mall Dental PC's NPI number?
- Roosevelt Field Mall Dental PC's National Provider Identifier (NPI) is 1073638151, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Roosevelt Field Mall Dental PC?
- Roosevelt Field Mall Dental PC is classified in the NPPES registry as Periodontics (Dental Providers).
- Where is Roosevelt Field Mall Dental PC located?
- Roosevelt Field Mall Dental PC's practice location on file with NPPES is 630 Old Country Road, Garden City, NY 11530.
- What is Roosevelt Field Mall Dental PC's phone number?
- The practice phone number listed in the NPPES registry for Roosevelt Field Mall Dental PC is (516) 294-1919.
- Who is the authorized official for Roosevelt Field Mall Dental PC?
- The authorized official listed on Roosevelt Field Mall Dental PC's NPPES record is Alexander Mikhailov, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Roosevelt Field Mall Dental PC's NPI active?
- Yes — Roosevelt Field Mall Dental PC's NPI (1073638151) is active in the NPPES registry as of the last update on 2025-09-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.