Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

South Shore Long Island Periodontics and Implantology

Organization Periodontics · NPI 1417755596

South Shore Long Island Periodontics and Implantology provides 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
Show map & directions

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