Individual provider Active NPI

Sima Tafreshi

  • Dentist
  • Syosset, NY
National Provider Identifier
1396104642
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS041703 Issued in PA
Practice address
128 Oakwood Dr
Syosset, NY 11791-5412
Phone
(718) 470-4120
NPI assigned
Feb 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS041703 PA Primary

Addresses

Primary practice location

128 Oakwood Dr
Syosset, NY 11791-5412

Mailing address

128 Oakwood Dr
Syosset, NY 11791-5412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190228002967 PA Order and Referring Only - DentistPractitioner - Dentist 2264771633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1396104642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 OAKWOOD DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117915412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 OAKWOOD DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117915412",
            "telephone_number": "718-470-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAFRESHI",
        "first_name": "SIMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

Verify at the official NPI Registry.