Individual provider Active NPI

Ziyad Effendi

  • Pediatric Dentistry
  • Brooklyn, NY
National Provider Identifier
1245691351
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
061555 Issued in NY
Practice address
55 Greene Ave Ste Lla
Brooklyn, NY 11238-6432
Phone
(718) 230-7676
NPI assigned
Mar 16, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 34507 TX
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 061555 NY Primary

Addresses

Primary practice location

55 Greene Ave Ste Lla
Brooklyn, NY 11238-6432

Mailing address

10627 Hinton Way
Manassas, VA 20112-5911
Phone (919) 727-9363

Other practice location 1

150 55th St
Brooklyn, NY 11220-2508
Phone (718) 630-8419

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
061555NYMDPediatric Dentist
34507TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1245691351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10627 HINTON WAY",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201125911",
            "telephone_number": "919-727-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 GREENE AVE STE LLA",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112386432",
            "telephone_number": "718-230-7676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 55th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112202508",
            "country_code": "US",
            "telephone_number": "718-630-8419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EFFENDI",
        "first_name": "ZIYAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-16",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "34507",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "061555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.