Individual provider Active NPI

Faranak Balazadeh, D.D.S

  • General Practice Dentistry
  • Forest Hills, NY
National Provider Identifier
1700959640
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
048224 Issued in NY
Practice address
7017 Austin St
3D
Forest Hills, NY 11375-4722
Phone
(718) 544-4440
Fax
(718) 233-2723
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 048224 NY Primary

Addresses

Primary practice location

7017 Austin St
3D
Forest Hills, NY 11375-4722

Mailing address

7017 Austin St
3D
Forest Hills, NY 11375-4722
Phone (718) 544-4440

Other identifiers 1

IdentifierTypeStateIssuer
02117742MedicaidNY

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
048224NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Dental Care Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700959640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7017 AUSTIN ST",
            "address_2": "3D",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754722",
            "telephone_number": "718-544-4440",
            "fax_number": "718-233-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7017 AUSTIN ST",
            "address_2": "3D",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754722",
            "telephone_number": "718-544-4440",
            "fax_number": "718-233-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALAZADEH",
        "first_name": "FARANAK",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02117742",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.