Active NPI
Ali Raza
- General Practice Dentistry
- Long Island City, NY
National Provider Identifier
1033788302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 062744
- Practice address
- 5011 Vernon Blvd
Long Island City, NY 11101-6511 - Phone
- (989) 327-3822
- NPI assigned
- Jun 22, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 062744 | NY | Primary |
Addresses
Primary practice location
5011 Vernon Blvd
Long Island City, NY 11101-6511
Mailing address
201 50TH Ave Apt 25E
Long Island City, NY 11101-5782
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
| License | State | Type | Specialty |
|---|---|---|---|
| 062744 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708300800000",
"number": "1033788302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 50TH AVE APT 25E",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111015782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5011 VERNON BLVD",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111016511",
"telephone_number": "989-327-3822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAZA",
"first_name": "ALI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-22",
"last_updated": "2024-02-19",
"certification_date": "2024-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "062744",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Island City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.