Tarek Korban, DMD, MD
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · West Harrison, NY
NPI 1598095267 · NPPES record last updated Feb 23, 2022
Key facts
- NPI
- 1598095267
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 056648 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 21, 2026 through Jan 21, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056648 | NY | MD | Oral and Maxillofacial Surgery (Dentist) |
| 271535 | NY | MD | Oral & Maxillofacial Surgery (D.M.D.) |
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Facial and Oral Surgery Specialists PLLC | Oral & Maxillofacial Surgery | Current |
Accepting new patients |
Locations
55 W Red Oak Ln
White Plains, NY 10604
Phone (914) 500-8955
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 271535 | NY | |
| Surgery Physician | 208600000X | 271535 | NY | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 056648 | NY | Yes |
Addresses
Primary practice location
55 W Red Oak LN
West Harrison, NY 10604-3608
Mailing address
55 W Red Oak LN
West Harrison, NY 10604-3608
Phone (914) 500-8985
Other providers in West Harrison, NY
- Asma Khan
- Kayla Kilkenny
- Alex Hyundong Kim
- Heeyeon Kim
- Sergej Naumovich Konoplev
- Mimi Anne Kulinski
- Lara Back
- Jessica Larroy
- Chung-Han Lee
- Alyson Leffel
All providers in West Harrison, NY · Oral and Maxillofacial Surgery (Dentist) in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.