Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1205994068 Individual Practitioner Male Practitioner

Dr. Peter Ickowicz , DDS

Dentist - General Practice • Williston Park, NY

Professional Overview & Biography Verified Profile Summary

Dr. Peter Ickowicz, DDS is a registered healthcare professional specializing in Dentist - General Practice in Williston Park, NY. Practice services are available at 99 HILLSIDE AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

99 Hillside Ave
Suite M

Williston Park, NY 115962333

Telephone 5167467761
Fax 5167467296
Associated Practice Facility / Clinic
🏢 Bethesda Cardiac Care Facility NPI 1073673679

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Williston Park, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.2 Yrs
Regional Practice Density
13 Specialists

Practicing in Williston Park, NY (8411 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License NY 049075

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Dr. Michael Rothberg , DDS

Dentist - Oral and Maxillofacial Surgery

NPI 1154320448

Doctor of Dental Surgery

NPI 1356315857

Doctor of Optometry

NPI 1396811725

Doctor of Medicine (M.D.)

NPI 1417116708

Doctor of Philosophy (Ph.D.)

Sheri Scott Calleo , LMHC, CASAC

Counselor - Mental Health

NPI 1487998928

Licensed Mental Health Counselor, CASAC

Shamarie Allen-Sherman , MA

Nutritionist - Nutrition, Education

NPI 1578125910

Master of Arts

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 99 HILLSIDE AVE, SUITE M, WILLISTON PARK, NY 115962333 (Tel: 5167467761)

📍
Updated Business Mailing Address July 08, 2007

Registered at 99 HILLSIDE AVE, SUITE M, WILLISTON PARK, NY 115962333 (Tel: 5167467761)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as PETER ICKOWICZ, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #049075 in NY)

🟢
Initial NPI Registration & Enumeration December 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1205994068
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 05, 2006
Last Update: July 08, 2007
Sole Proprietor: Yes

Mailing Address

99 Hillside Ave, Suite M

Williston Park, NY 115962333

Phone: 5167467761

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.