Altay Khanmamedov, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

051162 Issued in NY

Practice address

315 W 57TH St
Suite 209
New York, NY 10019-3158

Phone

(917) 338-6358

Fax

(917) 470-9486

NPI assigned

Apr 18, 2006

Last updated

Jan 8, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alta Dental LLC

  • Dental Clinic/Center
  • Teaneck, NJ
  • NPI 1508698556
  NPD Authorized official
• Serene Dental LLC

  • Dental Clinic/Center
  • New York, NY
  • NPI 1518297852
  NPD (past) Authorized official

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262908800000",
    "number": "1437114170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 WEST 181 ST",
            "address_2": "#26",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W 57TH ST",
            "address_2": "SUITE 209",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193158",
            "telephone_number": "917-338-6358",
            "fax_number": "917-470-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANMAMEDOV",
        "first_name": "ALTAY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2010-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "051162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Paria Khani, L.AC.
• Katrina Khani
• Arkadiy Khanimov, PHARM D
• Daniel Khanimov, PHARM D
• Zain Khankan
• Ali Khanmohamadi, M.D.
• Azin Khanmohamadi, M.D.
• Alisha Tyagi Khanna
• Ankush Akshay Khanna, D.M.D.
• Anushka Khanna, DO

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; 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.