Individual provider Active NPI

Frank M. Heravi, D.D.S

  • Dentist
  • New Hyde Park, NY
National Provider Identifier
1730170721
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
46017-1 Issued in NY
Practice address
1521 Jericho Tpke
New Hyde Park, NY 11040-4712
Phone
(516) 616-4900
Fax
(516) 282-2500
NPI assigned
Oct 31, 2005
Last updated
Apr 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 46017-1 NY Primary

Addresses

Primary practice location

1521 Jericho Tpke
New Hyde Park, NY 11040-4712

Mailing address

1521 Jericho Tpke
New Hyde Park, NY 11040-4712
Phone (516) 616-4900

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
46017-1NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ny Smile Destination Dental Cate PC, Inc. CurrentSince Sep 23, 2024 Accepting new patients
DRS Heravi & Kermanshahchis' Dental Care PC, Inc Dentist PastSince Aug 18, 2024 Accepting new patients

Locations

440 E 79th St
Apt 1F
New York, NY 10075
Phone (212) 697-6453

Organizations & group practices 2

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1730170721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 JERICHO TPKE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110404712",
            "telephone_number": "516-616-4900",
            "fax_number": "516-282-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 JERICHO TPKE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110404712",
            "telephone_number": "516-616-4900",
            "fax_number": "516-282-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERAVI",
        "first_name": "FRANK",
        "middle_name": "M.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "46017-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.