Active NPI
Sassan Rastegar, DDS
- General Practice Dentistry
- New York, NY
National Provider Identifier
1457429789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 041154
- Practice address
- 340 Madison Avenue
Suite 4B
New York, NY 10017 - Phone
- (212) 692-9090
- Fax
- (212) 687-6867
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- 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 | 041154 | NY | Primary |
Addresses
Primary practice location
340 Madison Avenue
Suite 4B
New York, NY 10017
Mailing address
PO Box 231006
Great Neck, NY 11023
Phone (212) 692-9090
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041154 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457429789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 231006",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "11023",
"telephone_number": "212-692-9090",
"fax_number": "212-687-6867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 MADISON AVENUE",
"address_2": "SUITE 4B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10017",
"telephone_number": "212-692-9090",
"fax_number": "212-687-6867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RASTEGAR",
"first_name": "SASSAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "041154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, 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.