Provider Demographics
NPI:1942097647
Name:MONDELLO, FELDMAN, AND MONDELLO DENTISTRY
Entity type:Organization
Organization Name:MONDELLO, FELDMAN, AND MONDELLO DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGAER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-888-8208
Mailing Address - Street 1:29 BARSTOW RD STE 107
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2209
Mailing Address - Country:US
Mailing Address - Phone:516-441-5300
Mailing Address - Fax:516-498-2391
Practice Address - Street 1:29 BARSTOW RD STE 107
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2209
Practice Address - Country:US
Practice Address - Phone:516-441-5300
Practice Address - Fax:516-498-2391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1093915829OtherDENTIST
NY1700083920OtherDENTIST
NY1366718074OtherDENTIST