Active NPI
Farajollah Soleimanzadeh, DMD
- General Practice Dentistry
- Bronx, NY
National Provider Identifier
1043833080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- NONE
- Practice address
- 234 E 149TH St
Bronx, NY 10451-5504 - Phone
- (718) 993-7909
- NPI assigned
- May 26, 2020
- 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 | NONE | NY | Primary |
Addresses
Primary practice location
234 E 149TH St
Bronx, NY 10451-5504
Mailing address
15 Woodfield LN
Glen Head, NY 11545-2242
Phone (516) 476-4509
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 |
|---|---|---|---|
| NONE | NY | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broadway Dental Group PLLC | General Practice | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Elmhurst, NY
- NPI 1740901867
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590451200000",
"number": "1043833080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 WOODFIELD LN",
"city": "GLEN HEAD",
"state": "NY",
"postal_code": "115452242",
"telephone_number": "516-476-4509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 E 149TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104515504",
"telephone_number": "718-993-7909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOLEIMANZADEH",
"first_name": "FARAJOLLAH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-26",
"last_updated": "2020-05-26",
"certification_date": "2020-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "NONE",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.