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

Roosevelt Field Mall Dental PC

Organization General Practice Dentistry · NPI 1073638151

Roosevelt Field Mall Dental PC is a General Practice Dentistry in Garden City, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
In the registry since
2007
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

630 Old Country Rd
Garden City, NY 11530
Phone: (516) 294-1919
Fax: (516) 294-6219
Show map & directions

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

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X (NY)
General Practice Dentistry Taxonomy 1223G0001X (NY)

Record details

NPI number1073638151
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alexander Mikhailov — Owner · (516) 294-1919
NPI enumeratedMarch 20, 2007
Last updated in NPPESSeptember 11, 2025
Mailing address630 Old Country Road, Garden City, NY 11530

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