Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

99-04 57th Avenue, Inc

Organization Dental Clinic/Center · NPI 1679977680

99-04 57th Avenue, Inc is a Dental Clinic/Center in Corona, New York. Licensed in New York. Registered with an NPI since 2014.

Licensed in
NY
In the registry since
2014
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9904 57th Ave Ste LH
Corona, NY 11368-3746
Phone: (718) 760-0471
Fax: (718) 760-4739
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X · Licence 0438701 (NY)

Record details

NPI number1679977680
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Maria Acebo — Owner · (718) 760-0471
NPI enumeratedOctober 20, 2014
Last updated in NPPESOctober 20, 2014
Mailing address9904 57th Ave, Suite Lh, Corona, NY 11368-3746

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