Individual provider Active NPI

Mafujul Hasan, DDS

  • Dentist
  • Sunnyside, NY
National Provider Identifier
1528057684
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
044293 Issued in NY
Practice address
4014 Greenpoint Ave
Sunnyside, NY 11104-3618
Phone
(718) 392-2858
Fax
(718) 392-2752
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 044293 NY Primary

Addresses

Primary practice location

4014 Greenpoint Ave
Sunnyside, NY 11104-3618

Mailing address

4014 Greenpoint Ave
Sunnyside, NY 11104-3618
Phone (718) 392-2858

Other identifiers 1

IdentifierTypeStateIssuer
01358805MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
044293NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mahfujul Hasan DDS,LLC Current Accepting new patients
Dhaka Dental PC Dentist Current Accepting new patients

Locations

17009 Hillside Ave
Jamaica, NY 11432
Phone (718) 291-2710

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1528057684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 GREENPOINT AVE",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111043618",
            "telephone_number": "718-392-2858",
            "fax_number": "718-392-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 GREENPOINT AVE",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111043618",
            "telephone_number": "718-392-2858",
            "fax_number": "718-392-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASAN",
        "first_name": "MAFUJUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "044293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01358805",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, NY

Sources for this page

Verify at the official NPI Registry.