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

Evergreen Dentistry, LLC

Organization Dental Clinic/Center · NPI 1790981579

Evergreen Dentistry, LLC is a Dental Clinic/Center in Bayside, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
In the registry since
2007
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4748 203rd St
Bayside, NY 11361-3039
Phone: (718) 578-1126
Fax: (718) 578-1126
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X · Licence 050969 (NY)

Record details

NPI number1790981579
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrew Kim — President · (718) 578-1126
NPI enumeratedJune 26, 2007
Last updated in NPPESAugust 22, 2020
Mailing address4748 203rd St, Bayside, NY 11361-3039

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