Raha Iraj, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

049847-1 Issued in NY

Practice address

5 Grace Church St
Open Door Family Medical Centers, Inc.
Port Chester, NY 10573-4911

Phone

(914) 937-8899

NPI assigned

Dec 18, 2006

Last updated

Mar 8, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1760545164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "address_2": "OPEN DOOR FAMILY MEDICAL CENTERS, INC.",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105624702",
            "telephone_number": "914-941-1263",
            "fax_number": "914-941-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GRACE CHURCH ST",
            "address_2": "OPEN DOOR FAMILY MEDICAL CENTERS, INC.",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734911",
            "telephone_number": "914-937-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRAJ",
        "first_name": "RAHA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "049847-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02746216",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yaritza Herrera, PA-C
• Sara Hios
• Ellie Christine Horn, LMSW
• Kathryn Bradley Howard, LCSW
• Matthew Huffman, LMFT
• Nikkita Jackson
• Pamela Jackson, PA-C
• Enrique Carlos Jinete, DPT
• Aspen Jordan-Platow
• Saad Kaif, DO

• Dentist in Port Chester, NY
• Providers in Port Chester, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.