Individual provider Active NPI

Hedieh Samadi, DDS

  • Dentist
  • New York, NY
National Provider Identifier
1740634450
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
049869 Issued in NY
Practice address
521 Park Ave
New York, NY 10065-8140
Phone
(212) 355-4777
NPI assigned
Apr 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 049869 NY Primary

Addresses

Primary practice location

521 Park Ave
New York, NY 10065-8140

Mailing address

521 Park Ave
New York, NY 10065-8140
Phone (212) 355-4777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240828000625 NY Practitioner - Dentist 1658753199 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049869NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Emusc, LLC CurrentSince Jul 15, 2024 Accepting new patients

Locations

8340 Woodhaven Blvd
Glendale, NY 11385
Phone (718) 441-0101

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": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1740634450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100658140",
            "telephone_number": "212-355-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100658140",
            "telephone_number": "212-355-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMADI",
        "first_name": "HEDIEH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-19",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "049869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.