Individual provider Active NPI

Justin Sedaghat, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • New York, NY
National Provider Identifier
1003443854
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
064181 Issued in NY
Practice address
515 Madison Ave # 28B
New York, NY 10022-5403
Phone
(516) 423-2131
NPI assigned
Mar 23, 2020
Last updated
Aug 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN27494 FL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 001460 NY
Student in an Organized Health Care Education/Training Program 390200000X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 064181 NY Primary

Addresses

Primary practice location

515 Madison Ave # 28B
New York, NY 10022-5403

Mailing address

13 Cherry LN
Kings Point, NY 11024-1121
Phone (516) 423-2131

Other names 1

  • Dr. Justin Seda Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN27494FLMDOral and Maxillofacial Surgery (Dentist)
064181NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Justin Sedaghat DDS PC CurrentSince Aug 17, 2025 Accepting new patients

Locations

515 Madison Ave
#28B
New York, NY 10022
Phone (212) 813-0707

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1003443854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 CHERRY LN",
            "city": "KINGS POINT",
            "state": "NY",
            "postal_code": "110241121",
            "telephone_number": "516-423-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MADISON AVE # 28B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225403",
            "telephone_number": "516-423-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDAGHAT",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN27494",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "001460",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "064181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTIN",
            "last_name": "SEDA",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.