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

South Shore Long Island Periodontics and Implantology

Organization Periodontics · NPI 1417755596

South Shore Long Island Periodontics and Implantology is a Periodontics in Wantagh, New York. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

3366 Park Ave
Wantagh, NY 11793-3770
Phone: (516) 826-4949
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X

Record details

NPI number1417755596
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joo Kim — Partner · (516) 826-4949
NPI enumeratedMarch 5, 2025
Last updated in NPPESMarch 5, 2025
Certification dateMarch 5, 2025
Mailing address3366 Park Ave, Wantagh, NY 11793-3770

Other providers in Wantagh