Tarek Korban, DMD, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

056648 Issued in NY

Practice address

55 W Red Oak LN
West Harrison, NY 10604-3608

Phone

(914) 500-8985

Fax

(914) 500-8986

NPI assigned

Jan 1, 2010

Last updated

Feb 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 21, 2026 through Jan 21, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Facial and Oral Surgery Specialists PLLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • White Plains, NY
  • NPI 1831762467
  NPD Authorized official

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

{
    "created_epoch": "1262304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1598095267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W RED OAK LN",
            "city": "WEST HARRISON",
            "state": "NY",
            "postal_code": "106043608",
            "telephone_number": "914-500-8985",
            "fax_number": "914-500-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W RED OAK LN",
            "city": "WEST HARRISON",
            "state": "NY",
            "postal_code": "106043608",
            "telephone_number": "914-500-8985",
            "fax_number": "914-500-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORBAN",
        "first_name": "TAREK",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-01",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "271535",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "271535",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "056648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asma Khan, MD
• Kayla Kilkenny
• Alex Hyundong Kim
• Heeyeon Kim
• Sergej Naumovich Konoplev, M.D.,PHD
• Mimi Anne Kulinski
• Lara Back
• Jessica Larroy
• Chung-Han Lee, MD, PHD
• Alyson Leffel, LCSW

• Oral and Maxillofacial Surgery (Dentist) in West Harrison, NY
• Providers in West Harrison, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.