Individual provider Active NPI

Natia Mosheshvili, DDS

  • General Practice Dentistry
  • Forest Hills, NY
National Provider Identifier
1407947724
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
050752 Issued in NY
Practice address
11055 72ND Rd
Suite L1
Forest Hills, NY 11375-5472
Phone
(718) 268-1028
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 050752 NY Primary

Addresses

Primary practice location

11055 72ND Rd
Suite L1
Forest Hills, NY 11375-5472

Mailing address

7020 108TH St
Apt 8B
Forest Hills, NY 11375-4449
Phone (917) 776-6823

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
I20160125001393 NY Order and Referring Only - DentistPractitioner - Dentist 5092018127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
050752NYMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Village Dental P.C. General Practice PastSince Feb 16, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407947724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7020 108TH ST",
            "address_2": "APT 8B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754449",
            "telephone_number": "917-776-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11055 72ND RD",
            "address_2": "SUITE L1",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755472",
            "telephone_number": "718-268-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHESHVILI",
        "first_name": "NATIA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.