Active NPI
Pourang Jahanshahi
- Orthodontics and Dentofacial Orthopedics Dentistry
- Woodside, NY
National Provider Identifier
1598831083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 053313-1
- Practice address
- 39-05 61St Street, 2ND Floor
Woodside, NY 11137 - Phone
- (917) 279-7713
- NPI assigned
- Nov 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 053313-1 | NY | Primary |
Addresses
Primary practice location
39-05 61St Street, 2ND Floor
Woodside, NY 11137
Mailing address
286 5TH Ave, Apt 4E
Brooklyn, NY 11215
Phone (303) 726-1699
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
| License | State | Type | Specialty |
|---|---|---|---|
| 053313-1 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388016000000",
"number": "1598831083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "286 5TH AVE, APT 4E",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11215",
"telephone_number": "303-726-1699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39-05 61ST STREET, 2ND FLOOR",
"city": "WOODSIDE",
"state": "NY",
"postal_code": "11137",
"telephone_number": "917-279-7713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAHANSHAHI",
"first_name": "POURANG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-27",
"last_updated": "2013-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "053313-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.