Individual provider Active NPI

Sobia Rafiuddin, DDS

  • General Practice Dentistry
  • Syosset, NY
National Provider Identifier
1417413352
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
061145 Issued in NY
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

Updated by the provider on Sep 23, 2020

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190730002547 NY Order and Referring Only - DentistPractitioner - Dentist 3274869128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
061145NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Sleep Solutions LLC PastSince Mar 30, 2025 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.

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

Verify at the official NPI Registry.