Payam Tabankia, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

052797-1 Issued in NY

Practice address

690 Bay St
Staten Island, NY 10304-3830

Phone

(718) 727-3333

Fax

(718) 727-8321

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1639203078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 E 29TH ST APT 6I",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166204",
            "telephone_number": "818-438-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 BAY ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043830",
            "telephone_number": "718-727-3333",
            "fax_number": "718-727-8321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABANKIA",
        "first_name": "PAYAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052797-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02782667",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Khanh Gia Ta, DO
• Furat Ali Younis Taani, M.D
• Daniel Udeozo Tabansi, PMHNP
• Ijeoma Tabansi
• Arabella Tabaquero
• Ester Tabay
• Kerissa Lee Tabona, CASAC-T

• General Practice Dentistry in Staten Island, NY
• Providers in Staten Island, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.