Panteha Mohammadalizadeh Rastgar, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

064736 Issued in NY

Practice address

4701 Queens Blvd
Sunnyside, NY 11104-1660

Phone

(718) 937-6750

NPI assigned

Sep 29, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1114707098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 QUEENS BLVD",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111041660",
            "telephone_number": "718-937-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 QUEENS BLVD",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111041660",
            "telephone_number": "718-937-6750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "718 10th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100197129",
            "country_code": "US",
            "telephone_number": "646-628-1211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAMMADALIZADEH RASTGAR",
        "first_name": "PANTEHA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-29",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "064736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miahaela Balaescu MD PC
• Michael Ahdoot, MD, PC (Progressive Ophthalmology)
• Michael R Zuckman, M.D., P.C.
• Silvia Crina Mihaila, RN
• Wendy Miron, LMSW
• Luz M. Molina, RN
• Amanda Louise Monk, EMT-B
• Luis Daniel Montalvo, MSW
• Montefiore Medical Center
• Hee Moon

• General Practice Dentistry in Sunnyside, NY
• Providers in Sunnyside, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.