Individual provider Active NPI

Neda Eghbali

  • Pediatric Dentistry
  • Valley Stream, NY
National Provider Identifier
1326544784
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
060520 Issued in NY
Practice address
509 W Merrick Rd Ste 103
Valley Stream, NY 11580-5252
Phone
(516) 599-1701
NPI assigned
Apr 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X 060520 NY Primary

Addresses

Primary practice location

509 W Merrick Rd Ste 103
Valley Stream, NY 11580-5252

Mailing address

Stony Brook School of Dental Medicine
151 Westchester Hall
Stonybrook, NY 11794-8711
Phone (631) 444-2557

Other practice location 1

Stony Brook School of Dental Medicine
151 Westchester Hall
Stonybrook, NY 11794-8711
Phone (631) 444-2557

Other practice location 2

Maimonides Medical Center
4802 10th Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

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
060520NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Laser Dentistry for Children LLC Pediatric Dentistry CurrentSince Jul 24, 2022 Accepting new patients
Helen Weinberg Ortho Group DDS PLLC PastSince Nov 9, 2021 Accepting new patients

Locations

509 W Merrick Rd
Ste 103
Valley Stream, NY 11580
Phone (516) 599-1701

Organizations & group practices 2

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1326544784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STONY BROOK SCHOOL OF DENTAL MEDICINE",
            "address_2": "151 WESTCHESTER HALL",
            "city": "STONYBROOK",
            "state": "NY",
            "postal_code": "117948711",
            "telephone_number": "631-444-2557",
            "fax_number": "631-444-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 W MERRICK RD STE 103",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805252",
            "telephone_number": "516-599-1701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Stony Brook School of Dental Medicine",
            "address_2": "151 Westchester Hall",
            "address_purpose": "LOCATION",
            "city": "Stonybrook",
            "state": "NY",
            "postal_code": "117948711",
            "country_code": "US",
            "telephone_number": "631-444-2557",
            "fax_number": "631-444-6013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Maimonides Medical Center",
            "address_2": "4802 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112192916",
            "country_code": "US",
            "telephone_number": "718-283-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGHBALI",
        "first_name": "NEDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "060520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.