Active NPI
Sobia Rafiuddin, DDS
- General Practice Dentistry
- Syosset, NY
National Provider Identifier
1417413352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 061145
- Practice address
- 175 Jericho Tpke Ste 108
Syosset, NY 11791-4501 - Phone
- (516) 364-1444
- Fax
- (516) 802-0039
- NPI assigned
- Feb 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 061145 | NY | Primary |
Addresses
Primary practice location
175 Jericho Tpke Ste 108
Syosset, NY 11791-4501
Mailing address
175 Jericho Tpke Ste 108
Syosset, NY 11791-4501
Phone (516) 364-1444
Other practice location 1
27005 76th Ave
New Hyde Park, NY 11040-1496
Phone (718) 470-3076
Other practice location 2
110 Smithtown Blvd
Nesconset, NY 11767-1748
Phone (631) 382-8585
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190730002547 | NY | Order and Referring Only - Dentist | 3274869128 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 061145 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sound Sleep Solutions LLC | Past | Accepting new patients | |
| Sachem Oral Surgery, PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Oral and Maxillofacial Surgery (Dentist)
- Nesconset, NY
- NPI 1669795332
-
- Dentist
- Nesconset, NY
- NPI 1750028924
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600819200000",
"number": "1417413352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 JERICHO TPKE STE 108",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117914501",
"telephone_number": "516-364-1444",
"fax_number": "516-802-0039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 JERICHO TPKE STE 108",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117914501",
"telephone_number": "516-364-1444",
"fax_number": "516-802-0039"
}
],
"practiceLocations": [
{
"address_1": "27005 76th Ave",
"address_purpose": "LOCATION",
"city": "New Hyde Park",
"state": "NY",
"postal_code": "110401496",
"country_code": "US",
"telephone_number": "718-470-3076",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "110 Smithtown Blvd",
"address_purpose": "LOCATION",
"city": "Nesconset",
"state": "NY",
"postal_code": "117671748",
"country_code": "US",
"telephone_number": "631-382-8585",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAFIUDDIN",
"first_name": "SOBIA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-15",
"last_updated": "2020-09-23",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "061145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syosset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.