Active NPI
Sepideh Dolatyar, DDS
- Dentist
- Brooklyn, NY
National Provider Identifier
1669881546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 63615
- Practice address
- 1122 Avenue Z
Brooklyn, NY 11235-5131 - Phone
- (424) 800-1716
- NPI assigned
- Aug 5, 2014
- Last updated
- Jul 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 63615 | CA | Primary |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 061448 | NY |
Addresses
Primary practice location
1122 Avenue Z
Brooklyn, NY 11235-5131
Mailing address
3120 Sawtelle Blvd Apt 305
Los Angeles, CA 90066-1474
Phone (424) 800-1716
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 |
|---|---|---|---|
| 63615 | CA | MD | Dentist |
| 061448 | 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": "1407196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657497600000",
"number": "1669881546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3120 SAWTELLE BLVD APT 305",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900661474",
"telephone_number": "424-800-1716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1122 AVENUE Z",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112355131",
"telephone_number": "424-800-1716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLATYAR",
"first_name": "SEPIDEH",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-05",
"last_updated": "2022-07-11",
"certification_date": "2022-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "63615",
"primary": true
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "061448",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.