Individual provider Active NPI

Mustafa Alkhandak

  • General Practice Dentistry
  • Yonkers, NY
National Provider Identifier
1073964987
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401415764 Issued in VA
Practice address
172 Murray Ave
Yonkers, NY 10704
Phone
(646) 719-4833
NPI assigned
Jun 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401415764 VA Primary

Addresses

Primary practice location

172 Murray Ave
Yonkers, NY 10704

Mailing address

172 Murray Ave
Yonkers, NY 10704

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
0401415764VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1073964987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 MURRAY AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "10704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 MURRAY AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "10704",
            "telephone_number": "646-719-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALKHANDAK",
        "first_name": "MUSTAFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.