Organization Active NPI

Emmet Dental PC

  • Dentist
  • Jamaica, NY
National Provider Identifier
1558379487
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
050370 Issued in NY
Legal business name
EMMET DENTAL PC
Practice address
8902 165TH St
MW 29
Jamaica, NY 11432
Phone
(718) 657-4838
Fax
(718) 657-0099
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Emil Yousefnejad Korori, DDS
Title
President
Phone
(718) 657-4838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 050370 NY Primary

Addresses

Primary practice location

8902 165TH St
MW 29
Jamaica, NY 11432

Mailing address

8902 165TH St
MW 29
Jamaica, NY 11432
Phone (718) 657-4838

Other identifiers 1

IdentifierTypeStateIssuer
02360025MedicaidNY

National Provider Directory

National Provider Directory

Locations

8902 165th St
Ste MW29
Jamaica, NY 11432
Phone (718) 657-4838

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558379487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8902 165TH ST",
            "address_2": "MW 29",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-657-4838",
            "fax_number": "718-657-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8902 165TH ST",
            "address_2": "MW 29",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-657-4838",
            "fax_number": "718-657-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMET DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KORORI",
        "authorized_official_first_name": "EMIL",
        "authorized_official_middle_name": "YOUSEFNEJAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-657-4838",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "050370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02360025",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.