NPIMap

Organization Active NPI

Alavi-Lin Dental PC

Doing business as Woodside Specialty Dental Clinic

  • Dental Clinic/Center
  • Woodside, NY
National Provider Identifier
1346581410
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
055123 Issued in NY
Legal business name
ALAVI-LIN DENTAL PC
Doing business as
Woodside Specialty Dental Clinic
Practice address
5123 Queens Blvd
Office 1, Dentist
Woodside, NY 11377-4587
Phone
(718) 440-9272
Fax
(718) 440-9797
NPI assigned
Mar 14, 2013
Last updated
Mar 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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

Authorized official

Name
Dr. Mohammad Alavi, DDSNPI 1871801738
Title
Prosthodontist
Phone
(310) 713-9588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 055123 NY Primary

Addresses

Primary practice location

5123 Queens Blvd
Office 1, Dentist
Woodside, NY 11377-4587

Mailing address

5123 Queens Blvd
Office 1, Dentist
Woodside, NY 11377-4587
Phone (718) 440-9272

Other identifiers 1

IdentifierTypeStateIssuer
03362672MedicaidNY

Other names 1

  • Woodside Specialty Dental Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

5123 Queens Blvd
Ofc 1
Woodside, NY 11377
Phone (718) 440-9272

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363219200000",
    "number": "1346581410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5123 QUEENS BLVD",
            "address_2": "OFFICE 1, DENTIST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774587",
            "telephone_number": "718-440-9272",
            "fax_number": "718-440-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5123 QUEENS BLVD",
            "address_2": "OFFICE 1, DENTIST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774587",
            "telephone_number": "718-440-9272",
            "fax_number": "718-440-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAVI-LIN DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-14",
        "last_updated": "2013-03-14",
        "status": "A",
        "authorized_official_last_name": "ALAVI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "PROSTHODONTIST",
        "authorized_official_telephone_number": "310-713-9588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "055123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03362672",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodside Specialty Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; 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.