Provider Demographics
NPI:1770160335
Name:TRICARICO, DOMINIQUE CATHERINE (DDS)
Entity type:Individual
Prefix:DR
First Name:DOMINIQUE
Middle Name:CATHERINE
Last Name:TRICARICO
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 STEWART AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4883
Mailing Address - Country:US
Mailing Address - Phone:516-294-0202
Mailing Address - Fax:
Practice Address - Street 1:THE SMILIST DENTAL GARDEN CITY
Practice Address - Street 2:901 STEWART AVE #200
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-294-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-28
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062733-011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice