Active NPI
Samer Rashad
- Pediatric Dentistry
- Howard Beach, NY
National Provider Identifier
1447712088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 104858
- Practice address
- 157-02 Cross Bay Boulevard
Suite 10
Howard Beach, NY 11414 - Phone
- (718) 323-5437
- NPI assigned
- Apr 3, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 061963 | NY | |
| Pediatric Dentistry | 1223P0221X | 104858 | CA | Primary |
Addresses
Primary practice location
157-02 Cross Bay Boulevard
Suite 10
Howard Beach, NY 11414
Mailing address
3006 Buckhaven
Chino Hills, CA 91709
Phone (909) 525-0430
Other practice location 1
9745 Laurel Canyon Road Suite A
Arleta, CA 91331
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 061963 | Other | NY | NEW YORK DENTAL LICENSE |
| 104858 | Other | CA | CALIFORNIA DENTAL LICENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694476800000",
"number": "1447712088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3006 BUCKHAVEN",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "91709",
"telephone_number": "909-525-0430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "157-02 CROSS BAY BOULEVARD",
"address_2": "SUITE 10",
"city": "HOWARD BEACH",
"state": "NY",
"postal_code": "11414",
"telephone_number": "718-323-5437"
}
],
"practiceLocations": [
{
"address_1": "9745 Laurel Canyon Road Suite A",
"address_purpose": "LOCATION",
"city": "Arleta",
"state": "CA",
"postal_code": "91331",
"country_code": "US",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RASHAD",
"first_name": "SAMER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-03",
"last_updated": "2023-09-12",
"certification_date": "2023-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "061963",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "104858",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK DENTAL LICENSE",
"identifier": "061963",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA DENTAL LICENSE",
"identifier": "104858",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Howard Beach, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.