| Arista Dental Care, Pc | |
|
3027 30th St Astoria NY 11102-2261 | |
| (718) 721-0330 | |
| Not Available |
| Full Name | Arista Dental Care, Pc |
|---|---|
| Speciality | Dentist |
| Location | 3027 30th St, Astoria, New York |
| Authorized Official Name and Position | Michael Kokolis (OWNER) |
| Authorized Official Contact | 7187210330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arista Dental Care, Pc 3027 30th St Astoria NY 11102-2261 Ph: (718) 721-0330 | Arista Dental Care, Pc 3027 30th St Astoria NY 11102-2261 Ph: (718) 721-0330 |
| NPI Number | 1851861264 |
|---|---|
| Provider Enumeration Date | 11/28/2018 |
| Last Update Date | 06/03/2021 |
| Medicare PECOS PAC ID | 1456760933 |
|---|---|
| Medicare Enrollment ID | O20210513001163 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851861264 | NPI | - | NPPES |
| 02299109 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Michael Kokolis |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1932282324 PECOS PAC ID: 2961704093 Enrollment ID: I20210607002181 |
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