OrganizationActive
Evergreen Dentistry, LLC
NPI 1790981579 · Dental Clinic/Center · Bayside, NY
Evergreen Dentistry, LLC is a Dental Clinic/Center organization in Bayside, NY (NPI 1790981579).
Provider details
- NPI number
- 1790981579
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Andrew Kim, President(718) 578-1126
- License
- 050969 (NY)
Specialties & taxonomies
Ambulatory Health Care Facilities
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
4748 203rd St
Bayside, NY 11361-3039
Phone: (718) 578-1126
Fax: (718) 578-1126
Street-level locationGet directions
Mailing address
4748 203rd St
Bayside, NY 11361-3039
Registry dates
- Enumerated
- 2007-06-26
- Last updated
- 2020-08-22
Frequently asked questions
- What is Evergreen Dentistry, LLC's NPI number?
- Evergreen Dentistry, LLC's National Provider Identifier (NPI) is 1790981579, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Evergreen Dentistry, LLC?
- Evergreen Dentistry, LLC is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Evergreen Dentistry, LLC located?
- Evergreen Dentistry, LLC's practice location on file with NPPES is 4748 203rd St, Bayside, NY 11361-3039.
- What is Evergreen Dentistry, LLC's phone number?
- The practice phone number listed in the NPPES registry for Evergreen Dentistry, LLC is (718) 578-1126.
- Who is the authorized official for Evergreen Dentistry, LLC?
- The authorized official listed on Evergreen Dentistry, LLC's NPPES record is Andrew Kim, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Evergreen Dentistry, LLC's NPI active?
- Yes — Evergreen Dentistry, LLC's NPI (1790981579) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.