Organization Active NPI

Shahab Soleymani DDS PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Astoria, NY
National Provider Identifier
1134417892
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
045265 Issued in NY
Legal business name
SHAHAB SOLEYMANI DDS PC
Practice address
4105 30TH Ave
Astoria, NY 11103-2908
Phone
(718) 932-6212
Fax
(718) 932-2113
NPI assigned
Jul 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Authorized official

Name
Shhab Soleymani, DDS
Title
President
Phone
(718) 932-6212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 045265 NY Primary

Addresses

Primary practice location

4105 30TH Ave
Astoria, NY 11103-2908

Mailing address

4105 30TH Ave
Astoria, NY 11103-2908
Phone (718) 932-6212

National Provider Directory

National Provider Directory

Locations

4105 30th Ave
Astoria, NY 11103
Phone (718) 932-3395

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310688000000",
    "number": "1134417892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111032908",
            "telephone_number": "718-932-6212",
            "fax_number": "718-932-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111032908",
            "telephone_number": "718-932-6212",
            "fax_number": "718-932-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHAB SOLEYMANI DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-15",
        "last_updated": "2011-07-15",
        "status": "A",
        "authorized_official_last_name": "SOLEYMANI",
        "authorized_official_first_name": "SHHAB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-932-6212",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "045265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.