Individual provider Active NPI

Debora Zivari, DDS

  • Dentist
  • Forest Hills, NY
National Provider Identifier
1417040817
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0431631 Issued in NY
Practice address
69 10 Yellowstone Blvd
Foresthills, NY 11375
Phone
(718) 520-9106
Fax
(718) 520-6527
NPI assigned
Sep 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Dentist 122300000X 0431631 NY Primary

Addresses

Primary practice location

69 10 Yellowstone Blvd
Foresthills, NY 11375

Mailing address

69 10 Yellowstone Blvd
Foresthills, NY 11375
Phone (718) 520-9106

Other identifiers 1

IdentifierTypeStateIssuer
01212335MedicaidNY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0431631NYMDDentist
043163NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417040817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 10 YELLOWSTONE BLVD",
            "city": "FORESTHILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-520-9106",
            "fax_number": "718-520-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 10 YELLOWSTONE BLVD",
            "city": "FORESTHILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-520-9106",
            "fax_number": "718-520-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIVARI",
        "first_name": "DEBORA",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0431631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01212335",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.