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 provides 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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