IndividualActive
Alvin Heller, DDS MD
NPI 1710090303 · Periodontics · Lake Grove, NY
Provider details
- NPI number
- 1710090303
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Credential
- DDS MD
- Sex
- Male
- Sole proprietor
- No
- License
- 023221 (NY)
Specialties & taxonomies
Dental Providers
Practice location
2233 Nesconset Hwy
Ste 204 Stony Brook Professional Bldg
Lake Grove, NY 11755
Phone: (631) 585-3838
Fax: (631) 585-4997
Approximate (ZIP-level) locationGet directions
Mailing address
2233 Nesconset Hwy
Lake Grove, NY 11755
Registry dates
- Enumerated
- 2006-08-16
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.