Individual provider Active NPI

Waleed Ben Elchami, D.M.D

  • Dentist
  • New York, NY
National Provider Identifier
1104003276
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
055999 Issued in NY
Practice address
425 Madison Ave
Ste 1800
New York, NY 10017-1110
Phone
(212) 868-9321
Fax
(646) 335-0450
NPI assigned
Jan 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 055999 NY Primary
Dentist 122300000X 22DI02302000 NJ

Addresses

Primary practice location

425 Madison Ave
Ste 1800
New York, NY 10017-1110

Mailing address

425 Madison Ave
Ste 1800
New York, NY 10017-1110
Phone (212) 868-9321

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
22DI02302000NJMDDentist
055999NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1104003276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 MADISON AVE",
            "address_2": "STE 1800",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100171110",
            "telephone_number": "212-868-9321",
            "fax_number": "646-335-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MADISON AVE",
            "address_2": "STE 1800",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100171110",
            "telephone_number": "212-868-9321",
            "fax_number": "646-335-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELCHAMI",
        "first_name": "WALEED",
        "middle_name": "BEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-30",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "055999",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02302000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 15, 2016; 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.