Individual provider Active NPI

Arman Jacob Yazdan, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Jamaica, NY
National Provider Identifier
1225413867
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
1225413867 Issued in NY
Practice address
17836 Wexford Ter Apt 2E
Jamaica, NY 11432-3028
Phone
(718) 739-1300
Fax
(718) 739-0966
NPI assigned
Jul 24, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 1225413867 NY Primary

Addresses

Primary practice location

17836 Wexford Ter Apt 2E
Jamaica, NY 11432-3028

Mailing address

17836 Wexford Ter Apt 2E
Jamaica, NY 11432-3028
Phone (718) 739-1300

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
1225413867NYMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Blvd Oral Surgery Current Accepting new patients
Dental Group of Manhattan PLLC Current Accepting new patients
Anthony T.R. Green D.D.S.P.C. PastSince Aug 27, 2023 Accepting new patients

Locations

344 3rd Ave
New York, NY 10010
Phone (212) 679-9690

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1225413867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17836 WEXFORD TER APT 2E",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323028",
            "telephone_number": "718-739-1300",
            "fax_number": "718-739-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17836 WEXFORD TER APT 2E",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323028",
            "telephone_number": "718-739-1300",
            "fax_number": "718-739-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAZDAN",
        "first_name": "ARMAN",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-24",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "1225413867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.