Individual provider Active NPI

Jerry Ashrafi, D.M.D.

  • Pediatric Dentistry
  • New York, NY
National Provider Identifier
1356635734
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
056125-01 Issued in NY
Practice address
180 W End Ave Apt 1D
New York, NY 10023-4917
Phone
(212) 362-5517
Fax
(212) 787-9588
NPI assigned
Jun 3, 2011
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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 056125-01 NY Primary

Addresses

Primary practice location

180 W End Ave Apt 1D
New York, NY 10023-4917

Mailing address

180 W End Ave Apt 1E
New York, NY 10023-4917
Phone (617) 910-7106

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
056125-01NYMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Jerry H Ashrafi DMD Ma PLLC Pediatric Dentistry CurrentSince Dec 29, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1356635734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 W END AVE APT 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100234917",
            "telephone_number": "617-910-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 W END AVE APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100234917",
            "telephone_number": "212-362-5517",
            "fax_number": "212-787-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHRAFI",
        "first_name": "JERRY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-03",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "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": "056125-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.