Individual provider Active NPI

Samir Mahmoud Yhea, DENTIST DDS

  • Dentist
  • Elmhurst, NY
National Provider Identifier
1295871234
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
045339 Issued in NY
Practice address
8744 Britton Avenue
Elmhurst, NY 11373
Phone
(718) 507-1440
Fax
(718) 507-1820
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 045339 NY Primary

Addresses

Primary practice location

8744 Britton Avenue
Elmhurst, NY 11373

Mailing address

8744 Britton Avenue
Elmhurst, NY 11373
Phone (718) 507-1440

Other identifiers 1

IdentifierTypeStateIssuer
01721388MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160615001297 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2264723691

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045339NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295871234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8744 BRITTON AVENUE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "718-507-1440",
            "fax_number": "718-507-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8744 BRITTON AVENUE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "718-507-1440",
            "fax_number": "718-507-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YHEA",
        "first_name": "SAMIR",
        "middle_name": "MAHMOUD",
        "name_prefix": "Dr.",
        "credential": "DENTIST DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "045339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01721388",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.