Individual provider Active NPI

Ahmad Ali Hedayati, DDS

  • Periodontics
  • Briarcliff Manor, NY
National Provider Identifier
1407063480
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
040333 Issued in NY
Practice address
351 Elm Rd
Briarcliff Manor, NY 10510-2207
Phone
(914) 441-4169
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 040333 NY Primary

Addresses

Primary practice location

351 Elm Rd
Briarcliff Manor, NY 10510-2207

Mailing address

351 Elm Rd
Briarcliff Manor, NY 10510-2207
Phone (914) 441-4169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150701001265 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4486966637

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1407063480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 ELM RD",
            "city": "BRIARCLIFF MANOR",
            "state": "NY",
            "postal_code": "105102207",
            "telephone_number": "914-441-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 ELM RD",
            "city": "BRIARCLIFF MANOR",
            "state": "NY",
            "postal_code": "105102207",
            "telephone_number": "914-441-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDAYATI",
        "first_name": "AHMAD",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "040333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Briarcliff Manor, NY

Sources for this page

Verify at the official NPI Registry.