1300 Union Tpke, Suite 201, New Hyde Park, NY 11040
Phone
(516) 775-3737
Listed under
Periodontists, Specialty practices
NPI
1043417991
NPI status
Active in the NPPES registry
Provider type
Organization (practice, clinic or company)
Registered specialty (self-reported taxonomy)
Periodontics (1223P0300X)
License number on NPI record
039925 (NY)
Authorized official
Michael Shreck, President
NPI first issued
Jul 2, 2007
NPI record last updated
Jul 13, 2016
NPI 1043417991 is active in the federal NPPES registry (CMS) with Periodontics, an ADA-recognized dental specialty, as its primary taxonomy; license 039925 (NY) is listed on the record. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-09-30.
What these registry facts mean
The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an organization, so it may cover several clinicians at this location. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. Periodontists specialize in the gums and bone that support the teeth, including placing implants, gum and bone grafting, and treating gum disease. Dentists who are not specialists can also place implants; the specialty here is the one the provider registered as primary.
Checking credentials: the specialty shown is the one this provider registered with the NPI system. Your state dental board's license lookup confirms the license, and the American Board of Prosthodontics, the American Board of Oral and Maxillofacial Surgery and the American Board of Periodontology each list their board-certified members.