Black Hall Dental, P.C.
NPI 1336991876ActiveOrganization· Dentist· New Hyde Park, NY
Dentist in New Hyde Park, New York, registered in NPPES in April 2024, part of Black Hall Dental, P.C. The authorized official on file is Theresa Fan, DDS, Administrator. Enrolled in Medicare as dme supplier - oral surgery - dentist.
Overview
| NPI | 1336991876 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Black Hall Dental, P.C. |
| NPI issued | Apr 5, 2024 |
| Last updated in NPPES | Apr 5, 2024 |
| Certified by provider | Apr 5, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Oral Surgery - Dentist (NY) |
|---|
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