Individual provider Active NPI

Jaffer Ahmed Shariff, DDS, MPH, MS

  • Periodontics
  • New York, NY
National Provider Identifier
1598242422
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
000092 Issued in NY
Practice address
630 W 168TH St # 20
New York, NY 10032-3725
Phone
(212) 342-3008
Fax
(212) 305-9313
NPI assigned
Jul 24, 2018
Last updated
Jul 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 000092 NY Primary

Addresses

Primary practice location

630 W 168TH St # 20
New York, NY 10032-3725

Mailing address

630 W 168TH St # 20
New York, NY 10032-3725
Phone (212) 342-3008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181105001334 NY Order and Referring Only - DentistPractitioner - Dentist 6305199514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000092NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1598242422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # 20",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-342-3008",
            "fax_number": "212-305-9313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # 20",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-342-3008",
            "fax_number": "212-305-9313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARIFF",
        "first_name": "JAFFER",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "DDS, MPH, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "000092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.