Individual provider Active NPI

Ehab Amr, DDS

  • General Practice Dentistry
  • Albany, NY
National Provider Identifier
1558429233
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
042956-1 Issued in NY
Practice address
319 S Manning Blvd
Suite 102
Albany, NY 12208-1742
Phone
(518) 438-4401
Fax
(518) 438-4401
NPI assigned
Dec 5, 2006
Last updated
Feb 10, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 042956-1 NY Primary

Addresses

Primary practice location

319 S Manning Blvd
Suite 102
Albany, NY 12208-1742

Mailing address

319 South Manning Blvd.
Suite 102
Albany, NY 12208
Phone (518) 438-4401

Other identifiers 1

IdentifierTypeStateIssuer
02624775MedicaidNY

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

LicenseStateTypeSpecialty
042956-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234224000000",
    "number": "1558429233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 SOUTH MANNING BLVD.",
            "address_2": "SUITE 102",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-438-4401",
            "fax_number": "518-438-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S MANNING BLVD",
            "address_2": "SUITE 102",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081742",
            "telephone_number": "518-438-4401",
            "fax_number": "518-438-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMR",
        "first_name": "EHAB",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2009-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "042956-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02624775",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; 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.