Individual provider Active NPI

Raida Akhtar Yazdani, DDS

  • General Practice Dentistry
  • Garden City, NY
National Provider Identifier
1659992709
Registry record updated Nov 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
061825 Issued in NY
Practice address
66 Covert Ave
Garden City, NY 11530-3826
Phone
(516) 775-2330
NPI assigned
Apr 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 061825 NY Primary

Addresses

Primary practice location

66 Covert Ave
Garden City, NY 11530-3826

Mailing address

66 Covert Ave
Garden City, NY 11530-3826

Other practice location 1

3236 73rd St
East Elmhurst, NY 11370-1706
Phone (786) 510-5183

Other practice location 2

3236 73rd St
East Elmhurst, NY 11370-1706
Phone (786) 510-5183

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

LicenseStateTypeSpecialty
061825NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gentle Dentistry of Lancaster, PLLC General Practice CurrentSince Dec 6, 2022 Accepting new patients

Locations

66 Covert Ave
Stewart Manor, NY 11530
Phone (516) 775-2330

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669507200000",
    "number": "1659992709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 COVERT AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 COVERT AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303826",
            "telephone_number": "516-775-2330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3236 73rd St",
            "address_purpose": "LOCATION",
            "city": "East Elmhurst",
            "state": "NY",
            "postal_code": "113701706",
            "country_code": "US",
            "telephone_number": "786-510-5183",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3236 73rd St",
            "address_purpose": "LOCATION",
            "city": "East Elmhurst",
            "state": "NY",
            "postal_code": "113701706",
            "country_code": "US",
            "telephone_number": "786-510-5183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAZDANI",
        "first_name": "RAIDA",
        "middle_name": "AKHTAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2022-11-27",
        "certification_date": "2022-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.