Individual provider Active NPI

Aynaz Khodayari, DDS

  • Dentist
  • Bronx, NY
National Provider Identifier
1487473526
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
063961 Issued in NY
Practice address
260 E 188TH St
Bronx, NY 10458-5302
Phone
(347) 640-1403
NPI assigned
Oct 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 063961 NY Primary

Addresses

Primary practice location

260 E 188TH St
Bronx, NY 10458-5302

Mailing address

50 W 34TH St Apt 18C9
New York, NY 10001-3090
Phone (347) 640-1403

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
I20250203001928 NY Practitioner - Dentist 7911436100 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
063961NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Union Community Health Center, Inc. CurrentSince Jan 20, 2025 Accepting new patients

Locations

2016 Bronxdale Ave
Ste 303
Bronx, NY 10462
Phone (718) 792-7972

2021 Grand Concourse
Bronx, NY 10453
Phone (718) 299-2800

260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236

Organizations & group practices 1

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": "1728259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1487473526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W 34TH ST APT 18C9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013090",
            "telephone_number": "347-640-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 E 188TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585302",
            "telephone_number": "347-640-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODAYARI",
        "first_name": "AYNAZ",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.