Ny Smile Destination Dental Cate PC, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

NY SMILE DESTINATION DENTAL CATE PC, INC.

Doing business as

NY Smile Destination

Practice address

440 E 79TH St Apt 1F
New York, NY 10075-1407

Phone

(212) 697-6453

Fax

(646) 882-6888

NPI assigned

Sep 18, 2024

Last updated

Sep 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Frank Heravi, DDSNPI 1730170721

Title

Owner/President

Phone

(516) 384-7215

Specialties & licenses 1

Addresses

Other names 1

• NY Smile Destination Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Frank M. Heravi, D.D.S

  • Dentist
  • New Hyde Park, NY
  • NPI 1730170721
  NPD Authorized official
• Mozhgan Kermanshahchi, DDS

  • General Practice Dentistry
  • New Hyde Park, NY
  • NPI 1407041635
  NPD (past)

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1215764766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E 79TH ST APT 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751407",
            "telephone_number": "212-697-6453",
            "fax_number": "646-882-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E 79TH ST APT 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751407",
            "telephone_number": "212-697-6453",
            "fax_number": "646-882-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NY SMILE DESTINATION DENTAL CATE PC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "HERAVI",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "516-384-7215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NY Smile Destination",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ny Society for the Relief of the Ruptured and Crippled Maintaining the (Hospital for Special Surgery-OMS)

• Dental Clinic/Center in New York, NY
• Providers in New York, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.