Active NPI
Eldad Simantow-Mazlumi, DMD
- Dentist
- Rochester, NY
National Provider Identifier
1306155171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 058097
- Practice address
- 625 Elmwood Ave
Rochester, NY 14620-2913 - Phone
- (585) 275-5051
- NPI assigned
- Sep 28, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 058097 | NY | Primary |
Addresses
Primary practice location
625 Elmwood Ave
Rochester, NY 14620-2913
Mailing address
625 Elmwood Ave
Rochester, NY 14620-2913
Phone (516) 233-7967
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 058097 | NY | MD | Dentist |
Interoperability endpoints
- esimantowmazlumi2060391@nychhc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486598400000",
"number": "1306155171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 ELMWOOD AVE",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146202913",
"telephone_number": "516-233-7967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 ELMWOOD AVE",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146202913",
"telephone_number": "585-275-5051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMANTOW-MAZLUMI",
"first_name": "ELDAD",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-28",
"last_updated": "2017-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "058097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.