Individual provider Active NPI

Pooria Shahin

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1700115946
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
055045 Issued in NY
Practice address
719 Franklin Ave
Brooklyn, NY 11238-4704
Phone
(917) 815-0825
NPI assigned
Dec 17, 2009
Last updated
Jul 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 055045 NY Primary

Addresses

Primary practice location

719 Franklin Ave
Brooklyn, NY 11238-4704

Mailing address

180 Riverside Blvd Apt 16M
New York, NY 10069-0812
Phone (404) 936-3225

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
055045NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1700115946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 RIVERSIDE BLVD APT 16M",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100690812",
            "telephone_number": "404-936-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 FRANKLIN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112384704",
            "telephone_number": "917-815-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHIN",
        "first_name": "POORIA",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-17",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "055045",
            "primary": true
        }
    ],
    "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 18, 2012; 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.